In 2001, HealthPartners began purchasing predictive algorithms that would identify plan members who were heading for a medical crisis, allowing them to intervene in these more complicated cases to improve care. Karen Lloyd, who had recently joined as the health plan’s first senior director of behavioral health, wondered why the same thing couldn’t be done in her area. The answer, at the time, was that no such algorithms were available for behavioral health.
“So we built them instead,” Lloyd says. “We spent over a year [creating] special outreach, engagement, and case management approaches for behavioral health conditions. Then, in June 2003, we started the program.”
Patients singled out by the algorithms get a letter in the mail from HealthPartners, letting them know that they are entitled to free telephone consultations to help them understand their conditions and treatment options. Some call and express interest; others receive follow-up phone calls from case managers. Either way, trained staffers help patients get past the barriers that prevent them from thriving.
“One [example] was a member who’d been drinking more and more vodka,” Lloyd recalls. “Over the course of 20 years, he got to the point where he was waking up at night to drink in order to keep his blood alcohol level high enough that he was comfortable. We sent him the letter and he called back right away. He was getting quite desperate."
It took more than 60 days of phone consultations to get the man into treatment. Then the case manager continued to support him as he entered Alcoholics Anonymous and worked on a long-term sobriety plan.
“He absolutely wanted to be in recovery, but it’s such a big change, and he had been trying to keep it concealed for so many years,” says Lloyd. “He has told us that he would not have gone into treatment had he not gotten that letter. Most of the people we reach out to realize that they’re not doing well, but they don’t know which way to turn. They’re really very grateful for the additional health care coaching and advocacy.”
Why was Lloyd driven to create the program? Over her 24-year career, she has found that patients with severe behavioral health conditions tend not to get the high-quality coordinated care they require. They also often don’t get the between-visit support they need to help them stay on their treatment plans. This program helps turn those problems around. As a result of the phone interventions, emergency visits for depression decreased nine percent among plan members in 2006, and hospital stays dropped by more than a third.
One of Lloyd’s greatest passions is her love for animals—especially horses, which she rides on her rural property at every opportunity. But even more than that, her colleagues know her for her deep commitment to improving the treatment of mental and chemical health problems. In the last couple of years, she has presented data at five national conferences, encouraging other health plans to adopt similar strategies.
“What they’re telling us is that we’re way out ahead on this kind of thing,” she says. “We have a nation-leading program.”
