Highmark Health is dedicated to its Mission statement “To create a remarkable health experience, freeing people to be their best,” supporting the Highmark vision of “A world where everyone embraces health.” This vision embraces both the physical health and mental well-being of our members. Behavioral Health concerns have reached an all-time high in the United States and present challenges to our members and health care providers. To complicate this, is the fact that there has been an increasing shortage of Behavioral Health Care Professionals across the United States. It is estimated that there may be a deficit upwards of 250,000 of Behavioral Health Practitioners, including Psychiatrists, as well as non-MD specialists/therapists, by the year 2025.¹
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2019, 61.2 million Americans were diagnosed with a mental and/or substance use disorder.² Among the Highmark population, this health care challenge exists as well. In January through December 2020, among the 2,535,727 members residing in Pennsylvania, Delaware, and West Virginia and actively enrolled in December 2020, Cotiviti* chronic conditions for behavioral health were attributed to the following number of members:
- Depression – 225,261 members (8.9%)
- Other Behavioral Health Diagnoses – 189,944 members (7.5%)
- Anxiety – 154,089 members (6.1%)
- Substance Abuse Disorders – 157,966 members (6.2%)
To address this growing problem, Highmark has developed this Behavioral Health Toolkit to assist Primary Care Physicians in the care delivery to this vulnerable population. The toolkit contains links to valuable and timely information sheets with best practice recommendations, screening tools, clinical practice guidelines, as well as additional tools and resources that can be incorporated into your practice.
*Cotiviti (a Healthcare Analytics company) developed a Claims Inquiry tool utilized by Highmark.
¹ U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Workforce, National Center for Health Workforce Analysis: National Projections of Supply and demand for Selected Behavioral Health Practitioners: 2013 – 2025 , November 2016, retrieved 12/22/2019 at https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/behavioral-health2013-2025.pdf
² Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-001, NSDUH Series H‑55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved 09/23/2020 at https://www.samhsa.gov/data/
Information Sheets for Behavioral Health Challenges Facing the Provider:
Clinical Practice Guidelines:
This Behavioral Health Toolkit is provided for general information. Highmark does not recommend particular treatments or health care services. This information is not intended to be a substitute for professional advice, diagnosis, or treatment. You should determine the appropriate treatment and follow-up with your patient. Coverage of services is subject to the terms of each member’s benefit plan. Additionally, state laws and regulations governing health insurance, health plans and coverage may apply and will vary from state to state.
Last updated on 7/28/2021