AmeriHealth HMO, Inc. and AmeriHealth Insurance Company of New Jersey (collectively, AmeriHealth) have changed the way we work with behavioral health providers by integrating the delivery of medical and behavioral health care. We recognize the need for a closer relationship with behavioral health clinicians who treat our members, and the importance of establishing a direct and mutually beneficial relationship.
Effective January 1, 2023, AmeriHealth insourced its behavioral health network and now directly contracts with behavioral health providers. Recently, AmeriHealth has expanded its covered behavioral health offerings — including mental health and substance use disorder services and member programs — to better support the whole health of your patients (our members). This gives members faster access to the type of care they need while also providing a wider range of clinicians to choose from.
Mental Health Incentive Program
This year, AmeriHealth introduced a new value-based incentive program — the Mental Health Incentive Program (MHIP) — for participating mental health professional and facility providers. The MHIP assesses the performance of our mental health providers to ensure they are delivering quality, accessible, and cost-effective care to our members.
The MHIP is comprised of two separate and distinct programs utilizing quality metrics for:
- Mental health outpatient/professional practices
- Mental health inpatient facilities
Both programs exclude substance use services. Listen to this message from Dr. Ryan Connolly, and learn more details about the MHIP by accessing the MHIP FAQ and the Mental Health Incentive Program guide on the PEAR Help Center (you must first log into PEAR to view the guide).
Connecting members to the right care quickly
The AmeriHealth Behavioral Health team offers many services that help your patients (our members) connect to the right care quickly.
Behavioral Health Case Managers: Registered nurses, licensed social workers, and professional counselors proactively identify members who may benefit from behavioral health services. These case managers look at a member's health history and care patterns to identify risk levels and offer support, including helping the member access care, schedule follow-ups, and stay aligned with their care plans.
Since making Behavioral Health Case Managers available in 2022, AmeriHealth has been able to identify four times more members in need of behavioral health services.
Behavioral Health Customer Care Advocates and Licensed Behavioral Health Professionals: This specialized team helps with care navigation services. They work together to provide risk screening and guide members to the right care options based on their individual needs.
Clinical Triage Team: This team supports high risk members by identifying priority needs, providing in-the-moment support, directly connecting the member to care (via warm transfer or direct scheduling), and following up to ensure safety and successful linkage. Care navigation services are available 24 hours a day, seven days a week to provide members with rapid connection to the right care.
Offering members additional support and tools
Quartet Health
AmeriHealth members enrolled in fully insured health plans can get additional support from Quartet Health*, a company that matches patients to mental health care that fits their needs and preferences and is covered by their health insurance.
Quartet Health also has a Virtual Clinic that it launched in 2022 with AmeriHealth. The clinic, which focuses on treating the needs of patients with serious mental illness, has a patient appointment availability guarantee within 48 hours.
AmeriHealth offers these navigational services free to eligible members.
Shatterproof Treatment Atlas tool
AmeriHealth members have access to the Shatterproof* Treatment Atlas® tool, which helps people search and compare addiction treatment facilities to find high-quality care for themselves or their loved ones.
Teladoc Health
Members have coverage for mental health coaching by Teladoc Health*, a digital resource offering personalized, evidence-based programs and dedicated support for a wide range of topics, including stress, depression, chronic pain, work-life balance, substance use, and anxiety. Mental health coaching is available 24/7 from a computer or the Teladoc mobile app.
Learn more
Providers are encouraged to share this information with their patients. You can learn more about the AmeriHealth expanded behavioral health offerings by visiting amerihealth.com and referring to Section 8: Behavioral Health in our Provider Manuals (New Jersey and Pennsylvania).
*Independent companies
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