Nearly every state in the U.S. faces a high or severe shortage of child and adolescent psychiatrists. A severe shortage, according to the American Academy of Child and Adolescent Psychiatry, means there are 17 or fewer practitioners per 100,000 children. Drill down to the county level and the picture is even more startling: most counties in the nation have no practitioner.
Filling these gaps in the nation’s mental health care workforce could take years. But the good news is that Blue Cross companies are already innovating to meet children’s behavioral health care needs right now.
In Pennsylvania, a growing network of providers, all on one platform
One of those models is flourishing in Philadelphia. Independence Blue Cross has invested in an online platform called Quartet. The idea is to make it easy for pediatricians, primary care doctors, parents and even customer service representatives to connect patients to mental health care right from the office.
“The platform is like an interstate highway system with an on-ramp at every office,” says Dr. Richard Snyder, executive vice president, Facilitated Health Networks for Independence BC and a former primary care physician.
Imagine, says Snyder, that a patient comes in for a checkup. In addition to performing a physical exam, the pediatrician can screen that patient for depression, anxiety or other mental health concerns. Rather than printing out a list of therapists or giving a caregiver a few websites to search, the pediatrician can plug the patient’s information into Quartet. The platform takes it from there, matching the patient with a provider and keeping an open line of communication with the pediatrician. Some doctors can even schedule an appointment for a patient right then and there.
Access to providers online, in person, in state or out
But how can a patient get matched if there aren’t enough youth mental health providers? Snyder says Independence BC and Quartet are tackling that problem by partnering with large national groups of providers to join the platform. These groups are both national in scale and local in nature, and through Quartet, they’re able to ensure accessibility is top priority for children and adolescents in Philadelphia. They can also accelerate the path to care for children and adolescents via telehealth or in-person visits. Children’s Hospital of Philadelphia has agreed to provide teletherapy. “If a pediatrician is already managing a patient, they may be able to help initiate treatment of depression or anxiety. They just need a little guidance to address those less complex needs,” says Snyder.
Providers who practice out of state but are licensed in Pennsylvania can also be on the platform and provide teletherapy. And Snyder says the health plan is linking up more specialists, including a service that provides therapy for eating disorders, a group specializing in the treatment of OCD and a practice that can help manage patients with serious mental illness, such as schizophrenia.
"The game changer is the fact that we can enable primary care providers and pediatricians to get their patients the care they need so much faster." - Dr. Richard Snyder, executive vice president, Facilitated Health Networks for Independence BC
Providers can connect patients to any kind of care needed, whether it’s in-person talk therapy, in-patient facilities or another level of care. “The game changer is the fact that we can enable primary care providers and pediatricians to get their patients the care they need so much faster,” says Snyder. “This is a sophisticated tool for pediatricians to connect with a growing range of specialists and ensure there’s follow up.”
Getting proactive about offering help
Letting members know what mental health services are available is just as important, says Snyder, before they seek treatment. Quartet can analyze Independence members’ insurance claims and identify patterns that might indicate the need for mental health care. The platform can then send a proactive text letting members know what kinds of mental health care are available if they want to reach out. The secure text doesn’t suggest a diagnosis or treatment. “It’s just one more opportunity to connect people to care they might not have known was available,” he says.
Another opportunity is a simple call to customer service. In April 2023, special training helped CSRs identify and refer 25 members, most of whom were calling about their benefits or with other questions, who might benefit from Quartet. Snyder says the goal is to ensure members reach the care they need, whether they’re speaking with a case manager, visiting the Independence BC member portal or learning about opportunities from mailings to members, employers or even school districts.
In Michigan, pediatricians and mental health care providers collaborate
Another model is well established in Michigan. Blue Cross Blue Shield of Michigan now has 213 primary care practices that use BCBS Michigan’s Collaborative Care model. BCBS Michigan provides incentives, training and ongoing support to practices that include psychiatric consultants and dedicated care managers who support pediatricians, family medicine physicians and internists. The upside is that patients may not need to be referred to a specialist for behavioral health concerns—specialists who may have long wait lists or be located far from a patient’s home—and can receive care faster.
In Rhode Island, a children’s mental health care team, PRN
In Rhode Island, pediatric “medical homes” have a long history. Many Ocean State pediatricians are accustomed to coordinating all of a patient’s care. Blue Cross & Blue Shield of Rhode Island ensures pediatricians have access to a children’s mental health consultation team that now works with more than 350 primary care and 68 pediatric practices across Rhode Island.
Helping pediatricians care for the whole patient carries other benefits
These models are making it easier for pediatricians to connect kids with mental health care providers. But there’s another benefit: allowing a team of doctors to care for a child’s whole health. There’s a new study, it seems, every day, exploring how our physical and mental health are intertwined. In one study, BCBS data linked a continuing rise in mental health conditions with an increased risk for chronic conditions among millennials. The CDC notes that chronic conditions can increase the risk for mental illness. It makes sense that treating the whole child might not only accelerate healing but prevent future illness.
Quartet is a leading tech-enabled behavioral health company that works with health plans, systems and provider groups to deliver speed to quality behavioral health care for all. The company is backed by venture funding from top investors including Independence Health Group. Quartet is in no way associated or affiliated with the Blue Cross and Blue Shield Association. Use of the Quartet name does not imply endorsement.
The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield Companies. All Blue Cross and Blue Shield Companies referenced are independent licensees of the Blue Cross Blue Shield Association.