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ABHW Member Company Spotlight – Aetna Behavioral Health

Over the course of the year, ABHW will be spotlighting member companies for the Perspectives section of the website. Interviews conducted with ABHW’s members will highlight programs and initiatives they are offering; preparations underway for the implementation of the Patient Protection and Affordable Care Act (ACA); and other current topics of interest.

For this piece, ABHW interviewed Hyong Un, M.D. Dr. Un is the Head of EAP Aetna Behavioral Health and Chief Psychiatric Officer for Aetna.  He has been with Aetna since 2002.  He is responsible for supporting the development of EAP and behavioral health strategic plans and quality management for Aetna Behavioral Health.  Dr. Un also oversees the development of innovative employee assistance, behavioral health disease and care management programs.  In 2010 Dr Un took the lead for Head of EAP product. In that role he has accountability for financial and operational success of the program as well as developing innovative EAP products that promote well-being and fosters integration of EAP in overall health.

How do you foresee Aetna accomplishing the goals set forth by the Affordable Care Act (ACA)?

Two of the goals of the ACA are coverage and health insurance portability. To help accomplish these goals set forth by the ACA, Aetna is establishing Accountable Care Organizations (ACOs).  ACOs are a collaboration of health care providers who are supported by health information technology, clinical decision support among providers, and the management and assessment of health outcomes. ACOs offer personalized care and engagement that better meet the needs of patients.  In addition to managing health outcomes, ACOs are responsible for managing patient costs.  Years of experience have provided Aetna vast amounts of data and analytics on patients, allowing them to refine underwriting, and identify risks. By using the vast amounts of data, Aetna is able to adjust and modify how care is delivered. Large provider organizations are collaborating with Aetna in order to provide state of the art care. Aetna’s collaborative work with large provider organizations will allow ACOs to achieve the goals of the ACA by providing patient care that is affordable and accessible.

What are some of the challenges facing MBHOs as we move forward with the ACA?

One of the biggest challenges is integration. There is a need to integrate behavioral health services into the ACOs.  Very often, behavioral health services and medical services are on different systems that are not compatible with each other. This can result in fragmented care. MBHOs must work closely with plans and providers in a collaborative way, consistent with the goals of the ACOs.  This also requires payment systems, data systems, and analytic systems that can work together. 

Can you tell us about some of the innovative technology that Aetna uses?

Some of Aetna’s innovative technologies include iTriage, My Active Health, and Medicity.

How is Aetna accomplishing the goals of Mental Health Parity and Addiction Equity Act (MHPAEA)?

MHPAEA requires group health plans that choose to offer both medical benefits and mental health or substance use disorder benefits to offer such benefits in parity.  This means that benefits for mental health/substance use disorder must be comparable to the medical surgical benefits. In order to comply with the MHPAEA interim final rule  Aetna has completed a review of current medical management strategies, policies, processes and evidentiary standards to assure that the mental health substance use disorder medical management processes are comparable and no more stringent than those used for medical/surgical conditions. Due to Aetna’s commitment to innovation, quality of care and integration, Aetna has developed a team of mental health specialists that work in close alignment with their medical care team to ensure a holistic approach to patient management. Aetna’s standard coverage will be in compliance with each of the key components of MHPAEA.

ABHW

Perspectives

CONSUMER TIPS: NAVIGATING YOUR PRIOR AUTHORIZATION.

Behavioral health is complex. Untreated behavioral health conditions, including both mental health and substance use disorders, have a significant impact on individuals, families, friends, and employers. Individuals with mental health conditions and/or substance use disorders need access to evidence-based services - the care that, based on scientific research, has been shown to...

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