Sustained stress and trauma caused by the aftermath of the COVID-19 pandemic, civil unrest, and mass violence has created an increased need for behavioral health services. However, individuals in communities nationwide continue to face challenges to engage and initiate care. This has resulted in higher rates of emergency department use, hospitalizations, and medication non-adherence for mental health needs generating substantial costs. More importantly, many are left without long-term treatment plans or means of accessing follow-up care to help them towards recovery. Centene continues to advance integrated care programs that provide an enhanced care management experience for members to ensure access to services and supports they need to achieve recovery and live their lives to the fullest.

Our Members Empowered to Succeed (METS) program supports providers through consultation and training to assist them in delivering a whole health and recovery-centered approach to care for individuals with heightened outpatient behavioral health needs. METS staff work to ensure providers have access to the tools and resources they need to engage members in developing treatment plans that consider the full scope of the member’s needs. This unique approach to care coordination allows for identification and linkage of healthcare and community-based supports that fit members’ strengths and health needs, while addressing everyday barriers they may be facing. The outcome is decreased dependence on unnecessary services, lower costs, greater medication adherence, and improved overall member care.

Insufficient care coordination can result in significant consequences for members including gaps in care, miscommunication, and redundancy in services and treatment. METS solves for these potential issues through enhanced cross-care team collaboration, with dedicated staff serving as the liaison for all providers including behavioral health, pharmacy, medical, dental, and social needs. This approach not only enables enhanced capabilities to monitor and evaluate treatment progress, but also ensures appropriate utilization of services while maximizing the use of community supports.

Research has shown mental health services that consider psychological, physical, and social supports improve rates of treatment adherence, remission, quality of life, and social functioning. By partnering with providers to create comprehensive care plans designed to address the various barriers that affect recovery, members have become more engaged in their treatment, which encourages independence and drives improved overall health outcomes.