Millennials now make up a quarter of the U.S. population. And recent findings from a Blue Cross Blue Shield The Health of America Report® reveal that a significant number of millennials are showing higher rates of chronic disease – including behavioral health conditions – than previous generations at the same age. That could have major implications for their health later in life. It may also require healthcare providers, insurers and other parts of the healthcare system to find new ways to care for millennials. To learn more about how to support millennials’ health, Blue Cross and Blue Shield companies hosted listening sessions across the country this summer and fall, hearing from millennials, their caregivers and advocates about the most pressing issues they see.
One common theme: millennials want more integrated physical and mental healthcare, possibly through their primary care physician. They say they want physicians to provide a “whole-person” approach to healthcare, in a convenient, compassionate way.
So what does that look like?
Care integration from a veteran of transformation:
Nancy Muldowney is a clinical nurse manager for patient-centered medical homes at BlueCross BlueShield of Tennessee (BCBS Tennessee). She’s helped practices across Tennessee improve the way they care for patients, with a focus on integrating mental and physical healthcare. She identifies three ingredients for success:
- Coordination: BCBS Tennessee embeds nurse care coordinators, a team Muldowney oversees, right in primary care doctors’ offices. “The role of the care coordinator is vital,” she says. They review patient records, follow up on test results or care that’s needed, and connect patients to specialists. They’re an integral part of the doctor’s entire healthcare team, and Muldowney says doctors appreciate the way coordinators can help connect the dots – or close gaps – in care.
- Support: Helping doctors incorporate behavioral healthcare is also essential. “All of our practices have had to integrate behavioral health components within their assessment questionnaires when seeing patients,” says Muldowney, a measure of the quality of the care they provide. And more are entering innovative payment arrangements that help physicians provide a more comprehensive, patient-focused range of services. That might, for example, give physicians the resources they need to add a behavioral health specialist to the team.
- Data: “Part of our integrated care is that we have an algorithm that can identify a patient who would benefit from outreach,” says Muldowney, such as a patient with high blood sugar levels who hasn’t filled a prescription for diabetes medication or who has had a number of emergency department visits for behavioral health concerns. Those might be indications a patient needs more support. Care coordinators can then take the initiative and follow up. To fully integrate care, says Muldowney, all of a patient’s healthcare providers must get better at sharing data. Without insight into care or test results a patient has received from a specialist, for example, primary care doctors aren’t as capable of following up on a patient’s care. “Ideally,” says Muldowney, “we would all be on the same [electronic medical] system.”
Care integration in action
Muldowney says these strategies are working to connect patients to the range of services they might need – through a single point of contact. For example, says Muldowney, a primary care doctor at one of the practices she works with identified not only a patient’s struggle to manage Type II diabetes but several unaddressed mental health needs. The patient had been unable to find a behavioral health provider. Meanwhile, her diabetes symptoms were worsening. The doctor, along with a BCBS Tennessee nurse manager and social worker collaborated to connect the patient with mental health treatment, including regular check-ins with the social worker for additional support. Simultaneously, the patient’s primary care team began educating the patient on managing her chronic disease. Since the interventions, the patient has reported less anxiety and better coping skills. And her blood glucose is now within a normal range.
BlueCross BlueShield of Tennessee is an independent licensee of the Blue Cross Blue Shield Association, an association of independent, locally operated Blue Cross and Blue Shield companies.