SCHENECTADY — Health insurer MVP Health Care plans to “directly administer” case management, utilization review, claims payment, and network management for all of its New York members that use behavioral-health services. That service will start in early 2020, the Schenectady–based insurer announced July 10. Boston, Massachusetts–based Beacon Health Options has administered behavioral-health services for MVP […]
SCHENECTADY — Health insurer MVP Health Care plans to “directly administer” case management, utilization review, claims payment, and network management for all of its New York members that use behavioral-health services.
That service will start in early 2020, the Schenectady–based insurer announced July 10. Boston, Massachusetts–based Beacon Health Options has administered behavioral-health services for MVP customers in New York since 2009.
Behavioral-health services could include mental health and substance-use disorder services.
The MVP announcement comes just over a month after health insurer Anthem Inc. (NYSE: ANTM) announced it had agreed to acquire Beacon Health Options. However, Christopher Del Vecchio, president and COO of MVP Health Care, told the Albany Times Union in a July 10 article that MVP’s decision had been under consideration for more than a year and wasn’t prompted by the acquisition news.
In addition, the Times Union article noted that a group of state behavioral-health agencies had told Crain’s New York Business that they had some payment issues with Beacon, but Del Vecchio said those concerns also weren’t a factor in MVP’s decision to bring the behavioral-health service administration in-house.
Del Vecchio is set to become MVP’s CEO on Sept. 1, replacing current CEO Denise Gonick, who is resigning.
MVP has a total membership of more than 700,000 people, including more than 600,000 in New York state, Michelle Golden, a PR staff person at MVP Health Care, said in an email response to a CNYBJ inquiry.
MVP Health Care noted in its release that, “on average,” 20 percent of its members have a diagnosed behavioral-health condition.
In addition, MVP customers with behavioral-health conditions can incur costs up to “six times more” than those without a behavioral-health diagnosis; and integrating behavioral and physical health care “significantly improves outcomes and lowers costs.”
MVP contends that its new health initiative will “empower primary-care and behavioral-health professionals to succeed at integrating patient care.”
Pending regulatory approval, when MVP assumes the administration of all services from Beacon Health Options, MVP’s behavioral-health network will include personalized service and support directly from the health insurer.
Behavioral-health providers will benefit from a new structure that lets them treat their patients “holistically,” and that “streamlines their reimbursements,” MVP contends.
MVP says it is working with Beacon Health Options to ensure that all areas of care delivery transition over well. Through the remainder of this year, as MVP builds its own behavioral-health network comprised of Beacon’s current providers and other services “deemed essential to MVP’s integrated-health vision,” members’ current 2019 benefits will not be affected.
A “fragmented” health-care delivery system has kept behavioral health and physical health apart, and as a result, the system has “lost sight of the fact that behavior often drives the morbidity of medical conditions,” MVP Health Care stipulated in its release. Fragmentation also contributes to “poor accessibility, less robust outcomes, and higher medical costs.”
“Our new streamlined approach to providing behavioral-health services will allow us to look at a patients’ entire continuum of care and evaluate the best way to improve their overall health and well-being,” Dr. Bruce Himelstein, chief medical officer at MVP Health Care, said. “Putting the patient back at the center of our health-care system is vital to improving outcomes and by implementing this new initiative, we will provide comprehensive, high quality care to our members.”
MVP Health Care operates a Syracuse office at 333 West Washington St., an Endwell office at 3660 George F Highway, and another location at 421 Broad St. in Utica, per its website.