Horizon and Quartet: Bridging New Jersey’s Mental Health Treatment Gap
When a leg is broken or the flu is wreaking havoc, most people are aware of what is happening – and know where to go for help. Mental health issues? Not so much.
By Suzanne Kunis, Director, Behavioral Health Solutions
Individuals may not even be aware that they are suffering, or may shield it from their friends, family and doctor. And even when a patient is cognizant of the situation, primary health care providers can struggle to find a behavioral health specialist that can address his or her needs within the in-network coverage guidelines of the patient’s insurance plan. These are among the major reasons why 60% of the nearly 44 million U.S. adults experiencing mental illness in a given year don’t receive the treatment they need. And that can result in devastating consequences for patients and their loved ones, as well as an estimated $193 billion in lost pay every year for mental health patients.
According to Dr. David Wennberg, MD, MPH, CEO of Quartet Health, identifying patients with mental health issues and connecting them with a behavioral health specialist is often a “big challenge for a primary care physician. It’s a real conundrum because they can’t find the right people to send them to.”
A new program, however, launched in the Garden State by Horizon Blue Cross Blue Shield of New Jersey, is aiming to help correct that problem. Working with Quartet Health, Horizon is offering an online platform that doctors can use to connect their patients with mental health providers in Horizon’s network. A physician provides basic information about the patient through a secure portal and Quartet connects the patient with a mental health professional and reports back to the referring physician the outcome of the visit.
But, Quartet is more than a referral platform. Using their proprietary technology, Quartet works with Horizon to identify patients with signs of undiagnosed mental health conditions and alerts a patient’s primary care doctor when an indicator is found. Armed with this information, a doctor can have a conversation with the patient to see if additional care makes sense. Those patients can then be referred to a mental health specialist through the platform.
By identifying the right, in-network behavioral health specialist and flagging patients at risk for mental illness, doctors are able to improve access to mental health care and improve patient outcomes.
"When we make a referral to Quartet, the patient is (connected with a provider) in less than 24 hours."
“I think it’s going to be the model of the future,” said Dr. George Ambrosio, Medical Director of FirstCare Medical Group, a primary care practice with offices in Lyndhurst and Verona. “When we make a referral to Quartet, the patient is (connected with a provider) in less than 24 hours.”
The problem is critical in New Jersey, which is ranked near the bottom half of all U.S. states with respect to mental health care access, according to a study by non-profit organization Mental Health America. Not only does lack of prompt and proper treatment negatively impact a patient’s health, but people with mental health conditions make six times as many emergency room visits and four times as many medical claims as other patients – with patients often bearing the burden of the added costs.
Since Horizon deployed Quartet’s platform in mid-2018, more than 2,000 of its members have been identified as potentially having an underlying, undiagnosed behavioral health condition, and their primary care physicians have been provided that information.
Another 1,000 have been referred by their primary care doctor for screening and treatment with one of the nearly 520 behavioral health providers who are part of the Quartet program. Quartet’s online platform enables real-time collaboration amongst the medical and mental health providers to ensure coordination of proper care.
Dr. Christopher Trotz, Executive Medical Director, Inspira Health Network, has seen up to 90 percent of referred patients successfully transition to a mental health provider. Bridging this gap is what makes Quartet so valuable, according to Dr. Wennberg: “Horizon is at the forefront of leadership in terms of realizing that this separation (between patients and providers) causes harm and potential suffering for patients.”