Behavioral health care demand is far outpacing supply. Research shows that 6 in 10 psychologists are not accepting new patients, and the national average waiting time for behavioral health services is 48 days. More than half of the U.S. population – 169 million people – live in areas with a shortage of mental health professionals. Those shortages are most acute in rural areas, and as a result, rural residents are more likely to receive behavioral health services from their primary care providers.
In an effort to improve access to behavioral health care, earlier this year Evernorth launched the Evernorth Behavioral Care Group. We sat down with Amy Ayrault, president of Evernorth Behavioral Care Group, to understand the strategy behind launching this outpatient behavioral health therapy practice, some early wins, and future plans.
Amy Ayrault, president of Evernorth Behavioral Care Group
Tell me about yourself and your role at Evernorth.
I am a licensed behavioral health clinician that has been working in the behavioral health field for over 20 years. I lead Evernorth Behavioral Care Group, which has allowed me to touch more lives than I ever could have done alone in private practice. My life’s great passion is centered on connecting individuals to behavioral health care and to demonstrate that people are improving and living a life full of vitality.
What is Evernorth Behavioral Care Group and why did we launch it earlier this year?
Evernorth Behavioral Care Group is an outpatient behavioral health therapy practice. There is greater demand today than ever for behavioral health services. We created Evernorth Behavioral Care Group after seeing the pain points and barriers experienced by individuals seeking behavioral health care and the administrative burden carried by behavioral health providers. Our answer was to create a simple care experience that enables patients to focus on feeling better, and clinicians to focus on delivering best-in-class care. I’m very proud to say that we have accomplished this task. But we are not done.
What’s the value proposition for patients?
From a patient perspective, one of the things I’m most proud of is that we are able to tee up available appointments within 72 hours. We offer flexibility in that appointments can be booked online, or by calling our care navigation team. Additionally, we’ve built a community of diverse therapists; ensuring that patients can get matched to culturally competent clinicians that can meet their clinical needs and preferences. We see that a lot of times when someone is seeking a therapist, they want to find someone that may have a similar lived experience, or a similar cultural background. Providers with lived experience have greater insight into the challenges that individuals face when navigating the system including stigmas and discrimination faced by those seeking mental health care.
We also spend a lot of time focusing on the enablement of measurement-based care. And in simple terms that really means how we determine whether the patients we serve are getting better. This measurement-based approach allows patients to have full transparency into their treatment progress. Our care navigation teams and patient support teams are available to assist patients with any concerns or questions throughout their treatment journey.
What’s the value for providers? How are we helping providers reduce administrative burden, and how does that impact patients?
Evernorth Behavioral Care Group provides all the necessary technology and tools that a provider needs to deliver care. We leverage everything we know about our providers and patients to make the best therapist recommendation, ensuring providers receive the most appropriate referrals based on their skills and preferences.
We take care of all administrative components of care delivery including scheduling of appointments, eligibility and benefits verification, claim submission, appeals, and record requests. This way, providers can spend their time doing what they do best, which is providing quality care to patients.
Additionally, providers are paid every two weeks, and that includes payments for no-shows or late cancelations of appointments. We also offer clinical consultation and continuing education for our providers, as well as competitive reimbursement rates.
It’s now been just over six months since we launched Evernorth Behavioral Care Group. Can you talk about some of the greatest achievements thus far?
Since launch we have stayed true to our promise of always having appointments available within 72 hours. In fact, our average time to an appointment is 1.5 days. We focus a lot of time and energy into enabling near immediate access, as we know the risks associated with delayed access to care, such as exacerbation of a person’s symptoms and missed opportunity to reduce total cost of care. We have more than doubled our geographic footprint, now operating in 13 states and Washington, D.C. Over 2,200 patients have engaged in care and more than 1,500 providers have joined our community.
What impact has Evernorth Behavioral Care Group made in terms of patient outcomes?
We are immensely proud of our initial quality outcomes. First, we are seeing 85% therapeutic alliance, which is defined as an individual completing at least three or more sessions with their therapist. This validates our efforts to match patients with the best provider for them, and also drives down total cost of care. Research from Evernorth has found that behavioral utilization is associated with medical and pharmacy savings of up to $2,565 in the first 15 months post diagnosis. Furthermore, there is continued savings 27 months post diagnosis of up to $3,321. The greatest savings were observed for patients who utilized more than three sessions with a therapist.
And because we have been measuring patient progress through PHQ9 and GAD7 scores, we know that 84% of all patients getting care with Evernorth Behavioral Care Group have experienced a clinically significant reduction in their depression or anxiety symptoms.
What’s next for Evernorth Behavioral Care Group?
There are three things I would love to call out. One, is in-person therapy. We started as a virtual-only therapy practice, but we always aspired to move into in-person care because we know from our own data that 50% of individuals still want to be seen in an office. We are very excited about the fact that in-person care will be coming later this year and will be fully scaled in 2025 across all markets.
The second focus for us over the course of the next few months is ensuring that Evernorth Behavioral Care Group is operating nationwide by April 2025. And finally, we will spend a lot of time and focus on developing the next stage of our clinical programs to support individuals with complex medical conditions, such as cancer.
