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Blue Cross Partners With Google-Backed Startup To Speed Mental Health Referrals

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One of the nation’s largest Blue Cross and Blue Shield plans has partnered with a behavioral health startup backed by Google’s venture arm and former Congressman Patrick Kennedy that helps primary care doctors better coordinate mental health treatment with psychiatrists.

Highmark, which operates Blue Cross and Blue Shield plans that provide health benefits to 5.2 million people in Pennsylvania and two other states, will add the technology of Quartet Health to speed the notoriously slow referral process to psychiatrists from primary care doctors .

Quartet will mine millions of Highmark Blue Cross claims to better identify patients with undiagnosed mental illness , addiction and behavioral health conditions. Quartet can also link patients via telehealth technology from their primary care doctor’s office for video consultations as well as online behavioral health.

“They will help us figure out who is diagnosed or should be diagnosed and we will use their technology to expedite and identify who is the appropriate mental health provider,” Dr. Duke Ruktanonchai, Highmark’s director of behavioral health, said in an interview. “We can then give data back to the primary care provider so there is better coordination of the patient’s care.”

It’s not uncommon for a referral to a psychiatrist or behavioral health specialist to take weeks. Mental health professionals often “work in practice setting silos separate and apart from primary care physicians, making it difficult to communicate and collaborate,” Kennedy said in a statement accompanying the announcement.

It’s the biggest deal thus far for Quartet, which already has relationships with two health systems in Massachusetts. Just last month, Quartet raised $40 million from GV, formerly known as Google Ventures, along with Oak HC/FT Partners, F-Prime Capital Partners and Polaris Partners.

Health insurers are suddenly escalating their investments in value-based mental health and related efforts that strive to improve quality and lower costs by better coordinating the care of the patient, making sure they take medications, get more care upfront in a doctor’s office or clinic before the patient gets sick and has a bad outcome that can lead to an expensive hospitalization.

Earlier this month, Cigna said it would partner with the American Society of Addiction Medicine to come up with an evidence-based approach to substance abuse treatment that could lead to value-based payments rather than the fee-for-service model that is lacking.

The health insurance industry is shifting more payments away from fee-for-service medicine that encourages doctors and hospitals to treat by volume of care delivered. The new value-based approach is one that rewards patient outcomes, making sure the right care is given in the right place and at the right time.

“This is about taking care of the entire person,” Highmark’s Dr. Rukanonchai said.

In Chicago last month, Patrick Kennedy told more than 200 people at the University of Chicago Politics Institute that the “benefit in real health care reform is going to be in the mental health space.”

“That’s where the gold is,” the former congressman from Rhode Island said. “It will be the way that insurance companies actually get the benefit of real healthcare reform.”

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