Aetna Behavioral Health Products for Employers
Research tells us time and again that mental health conditions such as depression have an impact on the everyday lives of employees and their families. The cost of this to the workplace is significant and growing.
Our goal is to help employees understand these issues by providing a variety of integrated services designed to assist them in effective problem resolution. Aetna Behavioral Health’s approach involves looking at the entire spectrum of health care needs, both physical and mental, and integrating services to maximize an individual’s opportunity for achieving better overall health. By using this approach, we are able to deliver a total member experience, one that embraces the interrelationship between mind and body.
We want to help your employees better understand this important mind-body connection by providing a variety of easy-to-use products and tools. We use information and technology to tailor materials to your employees’ unique needs.
Here are just a few of the decision-support tools and dedicated programs we offer:
The Reawakening Center
Depression is estimated to be the leading cause of disability worldwide. While nearly 19 million Americans experience depression annually, it’s a subject that’s rarely discussed openly. Seeking help for depression usually carries with it a stigma, which could explain why only 23 percent of adults diagnosed with depression actually receive treatment.* That's why Aetna developed the Reawakening Center.
The Reawakening Center is not your typical depression information portal. It provides information about depression in a way that is creative, entertaining, supportive and nonthreatening. The program helps participants to learn more about themselves, discover ways of dealing with their feelings and emotions, and develop insight and understanding into when they should seek professional help. The Reawakening Center also helps participants to understand their readiness for taking action so they can be more successful in addressing their feelings of depression, should they be at risk.
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Healthy Outlook Program®
Because depression often accompanies chronic illness, Aetna includes depression screening and referrals as part of our Healthy Outlook Program. This program reaches out to members at risk of the following chronic health conditions:
- Asthma
- Chronic heart failure
- Coronary artery disease
- Diabetes
- Low back pain
The program tries to help members deal more effectively with their physicians and take an active role in their health care.
Our disease-specific programs coordinate education, provider counseling, patient self-care and physician support. By identifying and managing a condition early, members can help avoid complications and improve their quality of life.
Once identified and enrolled in our Healthy Outlook Program, members receive quarterly mailings, a depression workbook, early intervention and, in some cases, individualized case management, with an emphasis on lifestyle changes.
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The Aetna Employee Assistance Program (EAP)
At Aetna, we believe in an integrated, total health focus, where an Employee Assistance Program (EAP) and other benefits are part of a continuum of care. Together they help you improve productivity, increase employee satisfaction and better manage health costs. We also believe that an EAP can serve as the early point of intervention for many problems and issues. For an EAP to be most effective, employees should use the program to help manage work and life issues before they become unmanageable. That's why Aetna has taken the traditional EAP one step further and put an emphasis on motivating employees to use this important benefit.
Our EAP is designed to be an inviting and dynamic program so employees will want to use it. The program features easy and confidential access to both telephonic and Web-based services so your employees can quickly find the resources they need. In addition, we assist you in using promotional and educational strategies to help employees discover the benefits of using an EAP.
Here are just some of the benefits of the Aetna EAP:
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Emphasis on appropriate care and assistance — Our goal is to direct and refer your employees and your management staff to information, assistance and care to address their specific needs. This can help your employees save time and effort, which helps them to remain productive on the job.
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Assistance in motivating employees — We provide the tools and guidance you need to promote Aetna's EAP effectively. Our promotional tool kit contains creative materials that can be customized to suit your company's needs. We also provide on-site seminars on relevant work/life topics to help your employees better understand the benefits of using their EAP.
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Ease of administration — Supplementing your other Aetna benefits programs with our EAP helps to ease the administrative burden and saves time by centralizing all of your benefits needs through a single account manager.
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Aetna's Successful Aging Program
Experience teaches us that the well informed make the wisest choices. We believe that providing members with access to and understanding of their benefits is an important element of the total mind-body approach to good health.
To complement our Employee Assistance Program (EAP), we offer a Successful Aging Program, continuing our commitment to help employees achieve enhanced health, productivity and satisfaction during and even beyond their working years, all the while helping them to control health care costs.
With an emphasis on successful aging, this program continues the many benefits offered in the EAP and includes the following elements:
- A focus on excellence in service delivery by providing a single point of contact (called an advocate, coach or retiree assistant) to address issues such as:
- Retirement planning.
- Elder care needs.
- Ways to navigate the health care maze.
- An empathetic approach in dealing with a retiree's unique needs (such as grief counseling, Medicare support and geriatric case management).
- Efficiency and effectiveness.
- Delivery of accurate and relevant information that is easy to navigate.
- Full integration with medical, group and pharmacy products.
Empowering people to make sound decisions is part of our business philosophy.
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DocFind®
Aetna Behavioral Health provides members with access to a multi-disciplinary network of health care professionals that includes psychiatrists, psychologists, clinical social workers, clinical counselors and certified addiction counselors. The network also includes intensive outpatient and other alternative settings, where qualified programs are available.
To find out which health care professionals participate in the Aetna Behavioral Health network, visit DocFind, our online directory. Please be sure to select the plan type that you are interested in.
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Aetna Depression Management
Depression is a common illness that affects up to 10 percent of the population and can last weeks, months or even years if not treated properly. To help manage this condition, Aetna Depression Management provides a dedicated care planner to coordinate the efforts of primary care physicians and mental health specialists in identifying and treating depression. Once identified and enrolled in the program, members receive educational materials and individualized care management, with an emphasis on appropriate treatment and adherence.
The program:
- Provides a turnkey depression treatment program for primary care physicians based on the clinically proven Three Component Model (3CM™) program designed by the MacArthur Foundation and further developed through trials run by Dartmouth Medical School and Duke University.
- Integrates medical and behavior benefit plans to help improve treatment so that a member’s quality of life and personal productivity can be increased. Aetna has been monitoring its efforts to integrate depression programs during the past year, and early results show integrating behavioral health and medical management can also reduce overall medical costs.
- Includes an Aetna-developed web-based continuing medical education program for the primary care physicians to bring information and educational materials to the doctors who first see patients.
- Provides training for office staff of participating primary care physicians who also work and interact with the patients.
- Gives access to Aetna case planners and psychiatrists who are on call throughout the day to answer questions and provide guidance for treatment that is needed outside the primary care office.
- Distributes member-targeted communications materials for use by the primary care physicians.
- Changes Aetna's reimbursement policy to encourage primary care physicians to more closely screen patients for depression. Many believe that screening and counseling for depression is not reimbursable, and the Aetna initiative will make it clear that benefit plans include that coverage.
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Depression Disease Management Program
The Depression Disease Management Program is currently available for fully and self-insured HMO members when members have both Aetna's medical and behavioral health benefits. Starting in January 2005, the program will be available for self-insured PPO members for an additional fee in two situations: (1) when offered as part of their employer benefits, along with Aetna's medical and behavioral health benefits, or (2) when offered along with Aetna's behavioral health benefits but without Aetna's medical benefits ("stand-alone").
The Depression Disease Management Program consists of the following components:
- Self-assessment for depression and comorbid disorders.
- Psycho-educational information available through an interactive voice response system (in English and Spanish).
- Online services related to depression and its treatment.
- Decision-support tools, including access to a clinician through the interactive voice response system, as well as case management telephone outreach, and integration with pharmacy, primary care physicians and behavioral health professionals.
- Case management outreach for members and primary care physicians to coordinate care and access to services, as well as enhance compliance.
Employees may be referred to Aetna's Depression Disease Management Program through the following channels:
- Inpatient psychiatric admission for a diagnosis of major depression, dysthymia, depression not otherwise specified or bipolar depression.
- Outpatient treatment for one of the above diagnoses.
- Pharmacy data indicating noncompliance with medications.
- Referral by a primary care physician.
Aetna's Depression Disease Management Program facilitates the application of evidence-based treatment intervention and enhances the cost-effective use of pharmacy benefits to maximize responses to antidepressant medication.
In 2005, this program will expand to manage alcohol use disorders and anxiety disorders.
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Medical Psychiatric Case Management
To help health care professionals address the needs of members who have both medical and behavioral health conditions that may affect the successful treatment of either condition, we have established a Medical Psychiatric Case Management program, currently available for members with fully insured and self-insured HMO plans. Starting in January 2005, this program will be available at an additional cost to self-insured PPO members in two situations: (1) when offered as part of their employer benefits, along with Aetna's medical and behavioral health benefits, or (2) when offered along with Aetna's behavioral health benefits but without Aetna's medical benefits ("stand-alone").
Aetna Patient Management and other specialty units screen members with medical conditions to determine if they also have any behavioral health issues. Examples include an alcohol-dependent member with diabetes who is currently drinking; a member with multiple medical problems, including depression, who is overwhelmed and not able to comply with treatment regimens; or a disabled member who is in psychological distress but cannot get to therapy.
Members who have behavioral heath issues and agree to a referral will be assigned a medical psychiatric case manager — usually a registered nurse. Case managers assess the member's needs, arrange for treatment services by health care professionals, and develop and implement a medical psychiatric case management plan if the member meets program admission criteria. This plan includes behavioral health services, as well as medical care.
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Mental Health/Substance Abuse (MH/SA) Carve-Out
Aetna brings more than 150 years of health care industry experience to your employees. Because we have learned that employers prefer having a selection of benefits options, we also offer our mental health/substance abuse (MH/SA) benefits as a "carve-out." That is, we give you the option to enhance and customize our MH/SA services and package them either with your existing Aetna medical plan or with medical benefits provided by other insurers. This gives you the flexibility to offer your employees the best benefits package available to suit their needs.
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We are dedicated to helping employers and their employees achieve health and financial security. We continue to integrate our products and leverage our data across medical, dental, pharmacy, behavioral health, disability, long-term care, life insurance, and wellness and prevention programs. In turn, we believe this integration can achieve better outcomes, enhance employee performance, increase employee satisfaction and better manage health costs.
We're here to help.
*Substance Abuse and Mental Health Services Administration, Office of Applied Studies. National Household Survey on Drug Abuse. 1994-97.
