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MVP undertakes significant efforts to improve care

MVP undertakes significant efforts to improve care

Insurer distributing grants and moving behavioral health management in-house
MVP undertakes significant efforts to improve care
The MVP building on State Street in Schenectady is pictured.
Photographer: Gazette file photo

SCHENECTADY — Schenectady-based health insurer MVP Health Care is undertaking two major initiatives it hopes will improve the health of its subscribers and of high-need members of the community:

MVP will stop outsourcing the management of its behavioral health services and instead administer them in-house so as to better integrate mental and physical health care, at an estimated cost of $6 million and an anticipated need to hire 80 new employees.

MVP also is teaming up with an organization that promotes preventative health to provide community-based nonprofits with grants totaling about $800,000 to address the social conditions that affect health.

The community health grants will begin next month; the transition of behavioral health management is expected to be completed early next year.

While the two initiatives are very different, MVP said they share the common thread of holistic care for its over-700,000 members.

PHYSICAL-MENTAL LINK

MVP announced last month that it had decided to transition behavioral health case administration away from Beacon Health Options, which has handled that function since 2009.

The insurer still needs regulatory approval for the change, which would result in it directly administering case management, utilization review, claims payment and network management for its New York members who receive behavioral health services such as substance abuse and mental health treatment.

About 20 percent of MVP’s members have a diagnosed behavioral health condition, and their health care costs can be six times higher than members who don’t have behavioral problems.

MVP said bringing management in-house will allow it to integrate physical and behavioral health care, which are often related if not directly linked.

Separating the two, MVP said, has obscured that direct link, reduced accessibility, raised medical costs and led to worse outcomes.

In a news release, MVP Chief Medical Officer Dr. Bruce Himelstein said: “Our new streamlined approach to providing behavioral health services will allow us to look at a patient’s entire continuum of care and evaluate the best way to improve their overall health and well-being.”

SOCIAL DETERMINANTS

This week, Healthy Alliance Independent Practice Association and MVP announced their partnership, the details of which they said are unique in the Capital Region:

High-need individuals will be connected to services such as housing, nutrition and transportation on the grounds that addressing the social determinants of health — the conditions in which a person is born, lives and works — will have a substantial impact on that person’s health. 

Healthy Alliance is a new initiative of Alliance for Better Health, which was established in 2015 as a Performing Provider System in New York state’s Delivery System Reform Incentive Payment program, an effort to reduce the cost of health care by increasing preventative care and improving community health. 

It works with more than 2,000 medical and social service providers in six Capital Region counties to do this, and its mission links closely with MVP’s in this area.

MVP and Health Alliance will provide grants to community-based organizations whose services improve the overall health of the needy. The funding also will connect medical providers with social service providers via Unite Us, a digital platform that will allow shared referrals and tracking of progress.

The two organizations believe this effort will improve the overall health of the community as well as individual patient experience.

They said Healthy Alliance is the first Independent Practice Association in upstate New York to focus exclusively on social determinants of health.

In a news release, Alliance for Better Health CEO Dr. Jacob Reider said:

“When people have safe housing, access to healthy food, convenient transportation, and other critical social needs met, they’re far more likely to seek and maintain preventive medical activities, which ends up reducing the frequency of emergency department visits and hospital admissions that cost our health system billions every year.”

MVP President Christopher Del Vecchio said: “Investing in the underlying social, economic, and environmental factors that contribute to an individual’s health reinforces our commitment not only to the overall health and wellness of our members, but to the entire Capital Region community.”

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