Like many insurers, UnitedHealthcare and Optum are dealing with a surge in digital solutions, according to Dr. Debra Nussbaum, senior director of behavioral health at Optum. And they’re trying to make sure the new solutions are as effective as the traditional solutions. During a recent interview at the Behavioral Health Tech conference, Nussbaum discussed these challenges and the ways she’s tackling them.
One issue Nussbaum is battling is making sure the industry doesn’t “over innovate and lose the effectiveness” when it comes to treating mental health conditions.
“So we’re trying to slow things down, but things keep coming so fast,” she said. “We have a healthcare economics team and we’re trying to do basically an analysis of these virtual solutions, and people are pushing coaching now. Coaching is very popular, and we want to innovate, we want to offer coaching. But is it effective? Is it safe? There are so many innovators in the market. How do I know what I want to back? It can’t be gut.”
So how should healthcare stakeholders measure which solutions to work with? Nussbaum said she’s often looking at claims history to see if there’s high engagement and better health outcomes.
“People are the best way to tell if a solution is working,” Nussbaum stated. “If they only have two claims, they’re not engaging people. They’re not connecting with people. I look in the claims data for length of engagement. I know by diagnosis how long someone should be in an episode of care. … I’m looking to see what’s happening with those people, like are they ending up in the ER? Are they ending up in higher levels of care? Are they staying with this solution and then living happily ever after? If we don’t have claims trends on them, I get very worried, because then they’re a brand new solution, and I don’t want my members to be the test case.”
She also has some advice for digital mental health solutions. Nussbaum said they should work together in the out-of-network space first so they can get evidence that the payer can look at.
“Everybody has out of network benefits,” she said. “We can’t bring them in just upon request. We need to know if their solution works. And of course, we vet. Are they evidence based? Are they doing what they’re supposed to be doing? How were they connected? How were they delivering?”
This challenge of point solution fatigue has been building for some time now, with employers also bearing the burden. However, there are some organizations working to gather evidence on which solutions are the most effective, such as the Peterson Health Technology Institute. The organization has so far released reports on diabetes solutions (largely unfavorable), musculoskeletal solutions (largely favorable) and hypertension solutions (mixed results). A future report will examine mental health companies.
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