Why Behavioral and Medical Health Go Hand in Hand at Tufts Health Plan

Supporting our members’ total health and wellbeing through a whole-person, integrated approach

Nearly 20% of American adults today live with behavioral health issues, ranging from depression and anxiety to substance use disorders and serious mental illness.¹ These issues not only affect individuals, but whole families, communities, and even workplaces: behavioral health issues can lead to lower productivity, increased absenteeism, and reduced job satisfaction.

Yet too often, people struggle to get the professional behavioral health care they need. Behavioral and medical health care are largely siloed in the American health care delivery system, making it hard to meet patients’ full spectrum of needs—mental, emotional, and physical. This is especially problematic given how interconnected behavioral and medical health are. People with behavioral health conditions have a greater risk of developing chronic diseases, while those with chronic diseases have higher rates of behavioral health conditions.²

People with behavioral health conditions have a greater risk of developing chronic diseases.

An integrated approach

At Tufts Health Plan, we believe that the way to best support our members’ total health and wellbeing is through a whole-person, integrated approach to medical and behavioral health. Rather than outsourcing behavioral health to a separate vendor—sometimes called a “carve-out” model—we provide a robust, end-to-end network of both medical and behavioral health care providers, paired with innovative clinical programs and services, all managed from within the four walls of our organization.

With this integrated approach, we can:

• Enhance access to high quality care and needed resources. Our members have a single point of contact for both their behavioral and medical health needs, making it easier for them to connect with the support, information, and resources they need.
   
• Strengthen the member experience with high-touch engagement. Through our communication platforms, member facing tools, and care management programs, we can stay in close contact with our members, helping ensure their needs are being met by our partners throughout the provider community.
   
• Deliver more efficient care. We use a single clinical system for both medical and behavioral health, which allows us to deliver highly coordinated care management and outreach for episodic to chronic needs. Our medical care managers, behavioral health care managers, and disease management teams will work side by side—literally, in some cases—using the same information systems. This means they can easily collaborate to help ensure that our members’ full range of needs are being met.

Rather than outsourcing behavioral health to a separate vendor, we provide a robust, end-to-end network of both medical and behavioral health care providers.

• Use data to identify health inequities. As an integrated plan, we have a single data set -  as opposed to one data set for medical and another for behavioral health, housed within a different company. As a result, we can easily see patient populations and individuals through a holistic lens. Armed with information, we can collaborate more effectively with our providers and community partners to promote health equity through programs that remove barriers to care.
   
• Continuously evaluate new approaches in care and program design. Our goal is to support a best-in-class behavioral health portfolio of member-centric services and support. To that end, we actively pursue partnerships with innovative, evidence-based behavioral health programs, resources, and tools that take a whole-person approach to care.

Finally, we can help ensure better value and more efficient health care delivery: Widely implement­ed, integrated behavioral health across the U.S. could create $38-68 billion in potential health care savings annually.³ At Tufts Health Plan, we’re committed to doing our part to help make it happen.

Contact us to learn more about how we’re driving better, more affordable care through integrated behavioral health care.  

Download the PDF

1. Mental Illness - National Institute of Mental Health (NIMH)
2. Association of Mental Health Disorders With Health Care Utilization and Costs Among Adults With Chronic Disease – JAMA Network Open, 8/23/2019
3. Potential economic impact of integrated medical-behavioral healthcare: Updated projections for 2017 – Milliman, 2/12/2018