Behavioral health care remains stagnant in its advancement, leaving countless patients to struggle without help. Cardiology, orthopedics, endocrinology, and other specialties of physical medicine have embraced emerging technology, and people are living longer, more active lives because of it. In comparison, mental health seems stuck in the past, displaying overreliance on the same tools it has for decades: therapy and medication.
The standard of care options are effective but do not address the real obstacles present for many patients in need, and for many aren’t the right fit. A reason for this lack of advancement is attributed to the lack of support (in terms of reimbursement) by health plans for new tools that have been developed. The good news is the Department of Health and Human Services (HHS) has openly supported establishing new payment pathways which should increase utilization of these new treatments.
Results are promising for the new category of devices with FDA clearance. Grounded in clinical research, these devices range from digital therapeutics for anxiety, PTSD, and depression, to biofeedback wearables that help patients regulate sleep and stress. This new technology demonstrates measurable improvements in patient outcomes and patient engagement. They’re not just gimmicks – they’re clinically validated tools delivering measurable clinical, economic, and patient satisfaction outcomes. Many of these new treatments have demonstrated both short and long-term symptom relief for patients.
In the case of mental health, digital therapeutics have demonstrated comparable clinical outcomes as traditional therapies but in many cases better adherence due to the convenience associated with the at-home element and ease of use. Fortunately, there are some innovative payors who are adopting these new technologies, but innumerably more lives can be positively impacted. Unfortunately, not enough health plans are prioritizing novel approaches to address this rapidly growing problem, which limits access to new treatments and delays the inevitable uptake of these options at the expense of people’s wellbeing today.
The current health plan-covered behavioral health treatment models consist of talk therapy, and medication. These approaches are essential to the range of treatments providers offer, but for many, they’re not fully addressing the needs of today’s patients who too often receive a one-size-fits-all approach to their specific behavioral health problems.
New mental health treatments based on technology will never replace traditional interventions. Rather these new technologies can provide a more robust treatment plan for the patient and improve their care through continuous support outside of the provider’s office. A key advantage of this new approach: empowering patients and guiding them to actively participate in their own healthcare.
It’s important to note that devices are not a threat to traditional providers. Devices work best when integrated into a broader care plan. Clinicians can receive new data that will enhance adherence to treatment while giving patients daily support tools. Moreover, the addition of these devices will extend the care being provided by a clinician to the patient’s home, ultimately creating greater adherence. We have seen the patient’s perspective of their health plan improve, as well as better engagement with their provider when it comes to their own mental healthcare.
Outdated insurance coverage policies are a major barrier to the greater adoption of behavioral health devices. It’s notable that a heart monitor can be covered without dispute, but a device that addresses abnormal respiratory patterns shown to lead to physiological distress is not. The effectiveness of these devices should no longer be debated. Most devices in this category take a measurement-based care approach. Data shows they work, and outcomes are exceptional. Patient engagement and satisfaction are better than expected, yet insurance coverage is lacking. This new (and much needed) era of mental health can only be driven by health plan acceptance. The key issue is whether health plans will expand coverage so more patients can access these new treatments.
The available care pathways prevent people from seeking care. Currently, 60% of individuals suffering from anxiety disorders do not seek professional help. An innovative move for health plans is to recognize mental health devices as legitimate clinical tools in the same way they have embraced emerging technology in other categories. The need for parity in terms of reimbursing them accordingly will provide advanced member support. This step allows for these useful treatments to be integrated into the standard model of care. For patients waiting months for access to behavioral health treatment, these devices could mean the difference between an ER visit and self-regulation, between personal resilience and personal crisis.
Photo: Professor25, Getty Images
Joseph Perekupka is the CEO of Freespira, the only company to offer a medication-free, FDA-cleared digital therapeutic treatment proven to reduce or eliminate symptoms of panic disorder, panic attacks and PTSD in 28 days. Joe is a proven healthcare leader with over 25 years of commercial experience in multiple leadership and functional medical device and digital health roles. He plays an active role with organizations such as the Digital Therapeutics Alliance and DTx societies, where he maintains co-chair roles that are focused on propelling the DTx industry growth, and is passionate about creating equitable access to care for mental health patients nationwide.
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