Integrated Behavioral Health

Integrated Behavioral Health is an unique combination of medical management and an Employee Assistance Program (EAP), which reduces unnecessary costs by guiding members who will benefit from short-term behavioral health counseling to the EAP at the point of entry. Members with acute mental health or substance abuse (MH/SA) conditions are managed in Case Management and referred to appropriate providers within the health plan’s network.

The program’s “clinical-first” service model provides all participants with a thorough psychosocial assessment. After the initial evaluation is completed, the member is guided into the most appropriate mode of care for their condition using referrals based on medical necessity guidelines.

Because half of all non-medication behavioral health cases can be addressed within the framework of an EAP short-term counseling model, Integrated Behavioral Health provides savings from would-be claims that were instead redirected into the EAP. For participants with acute MH/SA conditions, this integrated approach provides referrals to network providers and Case Management when necessary.

Program Highlights

  • Unique “clinical first” model guides „„members with acute MH/SA conditions to the most appropriate mode of care (Employee Assistance or Case Management).
  • Reduces the frequency of outpatient „„mental health and substance abuse (MH/SA) claims.
  • Promotes in-network utilization „„from members with acute MH/SA conditions.
  • Boosts Employee Assistance Program „„utilization, which can lead to increased employee productivity.

To learn more about the Integrated Behavioral Health program or AFMC’s Network Products and Services, call 800-624-4277 or e-mail.