News Spotlight

Leaders are afraid of the corner office. After the shooting of UnitedHealthcare CEO Brian Thompson, many leaders are afraid they will become the next targets and are unwilling to deal with the burnout and high pressure that comes with the job (Fortune).

Older women make workforce gains. Older women, particularly those aged 55 and older, are increasingly participating in the U.S. labor force, often occupying vital roles in healthcare, education, childcare, and the administrative sector (Washington Post).

Gen Z’s are NEETs. Gen Z’s are increasingly becoming NEETs (Not in Education, Employment, or Training) because of factors like economic instability, mental health challenges, and a mismatch between skills and job market demands (New York Times).

Stat of the Week

According to a recent study, only 50% of workers say they are extremely or very satisfied with their job and just 30% are highly satisfied with their pay.

To enhance job satisfaction, companies should focus on fostering a positive workplace culture that values employee contributions and promotes inclusivity. Offering competitive compensation, clear career development opportunities and flexible work arrangements can address key employee needs. Regular recognition of achievements, open communication channels, and active engagement in addressing employee feedback are essential for building trust and morale. Additionally, providing access to well-being programs, upskilling opportunities, and meaningful work can help employees feel supported and motivated. By aligning organizational goals with individual growth and ensuring a healthy work-life balance, companies can create an environment where employees thrive.

Deep Dive Article

What Employers Need to Know About Collaborative Care

When it comes to healthcare delivery, it’s becoming increasingly important for benefits professionals to deliver not only exceptional primary care to their members but also behavioral health services.

This is where collaborative care comes in. Collaborative care is an innovative way to integrate behavioral health with primary care. In practice, it allows patients with common mental health conditions such as depression and anxiety to receive their mental health care in their primary care office in a way that's high quality, evidence-based, and coordinated with their other medical conditions.

Collaborative care involves treating the whole person with a focus on health outcomes, helping patients get better rather than keeping them stuck in an endless cycle of therapy.

When employers can offer their employees a suite of behavioral health services anchored in exceptional primary care, then they’re on the path to better long-term health outcomes at a lower cost.

Effective collaborative care models provide a team-based approach to personalized care. . Best practices in this area include:

• 6- to 12-month tailored care plan coordinated by a care manager
• Ongoing check-ins for maintenance
• Care navigation support includes referrals, medication management with a primary care physician (PCP) and psychiatrist, and a wide range of services including therapy for both adults and children.

What does the patient journey look like in collaborative care? First, the patient visits with a PCP, who determines collaborative care eligibility and refers the patient to partner with a care manager. The care manager then creates a personalized care plan with the patient and checks in with the patient regularly. The care manager also coordinates across a wider care team—including an on-staff therapist and psychiatric consultant—and provides referral support. Finally, the patient graduates from the program and schedules follow-ups for maintenance.

Patients, providers, and the healthcare system all benefit from an effective collaborative care model.

Collaborative care gives patients compassionate whole-person care. In addition to receiving more efficient and less costly care, patients also receive care navigation support. Patients can be more comfortable sharing their concerns and have their issues addressed quickly before they escalate. Collaborative care also enhances convenience for patients, since their behavioral healthcare is attached to their PCP and primary care clinic. Finally, collaborative care is less stigmatizing for patients, giving them a more discrete way to address mental health issues.

Healthcare providers benefit from this model as well. According to Andrew Bertagnolli, PhD, who is National Medical Director of Virtual Behavioral Health Services at Amazon One Medical, the value for healthcare providers is in the integration approach of connecting primary care with behavioral health. “The mind and emotions influence not just the body, but also our ability to manage other health conditions that often go hand in hand,” Bertagnolli explains. “For example, depression and diabetes is a common set of comorbidities and one impacts the other.” Healthcare clinicians and teams also benefit from bringing extra expertise into the room in the form of a care manager and a psychiatric consultant.

Finally, as patients benefit from improvement of their mental health conditions, their coexisting medical conditions, and lower use of hospital and emergency room services, the healthcare system benefits with lowered costs. “There is evidence that care management models reduce overall cost of care,” Bertagnolli says. “And then we are able to help people get better, which is the paramount goal of the healthcare system as well as saving money.”

A growing body of research confirms that collaborative care works to help patients improve their health conditions through the partnership of primary care and behavioral health services, and that integrated primary care delivers better clinical outcomes.

Amazon One Medical has an behavioral health initiative called the Mindset Program, which integrates therapy and coaching within it’s primary care environment to address and manage the behavioral health needs of adult and pediatric members. Mindset facilitates early identification, intervention, and ongoing management of mental health disorders through a coordinated approach that blends primary care with specialized behavioral health services.

At One Medical, three-quarters (76%) of all members are screened for depression annually and receive follow up. For members who are enrolled in the Mindset program, around half (49%) have reported clinically significant reduction in PHQ-9 depression scores, and 58% of members reported clinically significant reduction in GAD-7 anxiety scores.

Other recent studies, as well as seminal research, support the effectiveness of the collaborative care model in terms of fewer hospitalizations and cost savings. An issue brief from the Bowman Family Foundation reviewed three studies examining the impact of the collaborative care model on total healthcare costs. The brief reported that the trio of studies “provide evidence that implementing COCM [the collaborative care model] in day-to-day primary care is associated with reductions in THCs [total healthcare costs], and that such reductions may occur as early as the first year and may increase over 3-4 years.” (Emphasis in original.)

Additionally, a 2008 study published in the American Journal of Managed Care compared usual care with the Improving Mood: Promoting Access to Collaborative Treatment (IMPACT) program for late-life depression to examine the long-term effects on total healthcare costs. The study concluded: “Compared with usual primary care, the IMPACT program is associated with a high probability of lower total healthcare costs during a 4-year period.”

We’re just at the beginning of recognizing the full potential of collaborative care. On the horizon over the next decade, the future may hold a much wider implementation of the model. The next frontier of collaborative care may also include helping people bridge the current gap in the behavioral healthcare delivery system.

Here are five core principles of effective collaborative care:

1. Team-based care. Includes a behavioral care manager who can deliver brief evidence-based psychotherapies and care coordination, collaborating with a PCP, and clear roles and goals around who is doing what.
   
2. Measurement-based treatment to target. Requires the collaborative care team to regularly use measures at the key moment of treatment decision-making, ensuring proactive treatment adjustments.
   
3. Population-based model. The care team ensures all patients in the program are included on a registry, proactively doing outreach and creating engagement, rather than only focusing on those who come back into care on their own.
   
4. Evidence-based treatments. The ability to offer patients a range of evidence-based treatments in a place they feel comfortable, ensuring that patients receive access to appropriate treatment aligned with diagnosis.
   
5. Quality metrics. Identifying what a successful program means through quality measures at the population health level to assess whether the program is achieving its goals, and regularly adjusting the system of care if metrics aren’t met.

​Download Amazon One Medical’s The Benefits of Collaborative Care Whitepaper to learn more.​

Thanks for reading — be sure to join the conversation on LinkedIn and let me know your thoughts on this topic!

Quote of the Week

“What we fear of doing most is usually what we most need to do."
​Ralph Waldo Emerson