A critical strategy shift
Matthew Collins, M.D., M.B.A. is BCBSRI’s executive vice president and chief medical officer, with comprehensive oversight for our medical management, care management, utilization management, and behavioral health management areas. Matt’s goals are ensuring our members get the right care at the right time in the right setting, while leading our efforts to control the increase of total medical expenses. He also brings a unique perspective to his role with a background as a family physician.
Even before the COVID-19 pandemic, as a nation we were already facing a growing crisis around pediatric behavioral health issues and concerns. According to Protecting Your Mental Health, the U.S. Surgeon General’s 2021 youth mental health advisory, “the challenges today’s generation of young people face are unprecedented and uniquely hard to navigate, and the effect these challenges have had on their mental health is devastating."
The study also points out national surveys which show significant increases in the prevalence of certain mental health challenges. Specifically, one shows that in 2019, one in three high school students – as well as half of female students – reported persistent feelings of sadness or hopelessness, an increase of 40 percent from 2009. These feelings are shaped by so many internal and external factors…genetics, relationships, social media/messaging, and more recently over the last few years, glaring spotlights on inequities, social injustices, the opioid epidemic, and gun violence, to name just a few.
And the pandemic has done nothing but further exacerbate this troubling trend, with fear, economic instability, isolation, and changing routines of the last few years creating more anxiety and stress in young people than ever before. The Surgeon General’s report goes on to point out that these issues are both treatable and preventable, albeit not an easy or quick “fix," that will require a reprioritization of children’s mental health across all corners of the healthcare system.
With this as a backdrop, Blue Cross & Blue Shield of Rhode Island (BCBSRI) has made pediatric behavioral health a bold core component of our new three-year strategy. How bold? By the end of the three years – in late 2025 – our goal is to have supported the mental health and well-being of 100,000 Rhode Island youths under age 18. Getting there will require enhancing collaboration and strategic partnerships with a wide range of stakeholders across Rhode Island, including our comprehensive network of providers and health systems.
This strategy has a triple “A" aim of improving access, awareness, and advocacy around pediatric behavioral health. Access means ensuring our network has culturally congruent, affordable benefits and programs that help members achieve a state of mental well-being. We’ll get there by contracting with existing mobile crisis intervention providers, expanding our network to include national vendors specializing in virtual mental and behavioral healthcare (including Brightline), and enhancing emergency department (ED) transitions of care by using RI Quality Institute (RIQI) alerts that alert BCBSRI when a member is admitted to the ED.
We’ve already made great strides in the area of expanding access – in response to the critical shortage of mental health services available locally, late last year we expanded access to pediatric and urgent behavioral health appointments with partners including Providence Behavioral Health (Providence and East Greenwich) and the Rhode Island Center for Cognitive Behavioral Therapy (RICBT), through its Rapid Response Program and at locations in East Providence, North Kingstown, Barrington, Lincoln, and Warwick. In addition, and since 2019, BCBSRI has partnered with James Andriotis, M.D., of Child and Family Psychiatry Inc. to provide increased access to psychiatry services for children and adolescents. The practice provides urgent appointments for BCBSRI pediatric members in need of an evaluation with a child and adolescent psychiatrist.
The second “A" is awareness, which is essential to helping reduce the stigma of behavioral health, as well as to increase understanding of different types of mental health conditions. Our goal is to do this by providing education to youths and their parents in partnership with several local community organizations. Specifically, we plan to partner with social emotional learning programs, sponsor mental health first aid events, create programming to destigmatize mental health in communities of color, and address racism and equity with behavioral healthcare providers.
The last piece of the strategy is advocacy, which will see BCBSRI partner with the community to improve the mental health system and reduce health disparities. We will work with employers, community groups, schools, and providers to build and invest in tools, programs, and resources aimed at promoting behavioral health wellness, mental health first aid, racial disparities, and pediatric anxiety.
There’s so much to do, but it’s imperative that we act now as we’re in the midst of a nationwide and statewide mental healthcare crisis. The system is grappling with unprecedented demand for behavioral health services, and BCBSRI is doing its part to expand access to this critical care, when children and their families urgently need professional help the most.
I wanted to take a minute to let you know that this is my last Provider Update column, as I am leaving Blue Cross as of 1 de febrero. It has been my great pleasure and honor to serve Blue Cross, the Rhode Island community, and especially you, our participating providers. Thank you for your support over the last several years, and I wish you the best!