Cityblock Health's 'secret sauce' for engagement in behavioral health

Community health workers are the "secret sauce" to driving engagement in behavioral healthcare at Cityblock Health, according to Ruby Mehta, head of behavioral health at Brooklyn-based Cityblock. 

Cityblock provides coordinated primary care, behavioral health, urgent care and other services in seven states. 

The company primarily serves individuals dually eligible for Medicare and Medicaid, and Medicaid beneficiaries. Cityblock leans on its community health partners, who are not always clinicians, but can form trusted partnerships to connect patients to care, Ms. Mehta told Becker's. 

"The community that we work with has a justified distrust of the healthcare system. The more we can show our legitimacy and that we really are here to help the better it is," Ms. Mehta said. 

The company has launched an advanced behavioral health model in all seven of its markets, Ms. Mehta said. The model which uses specialized community health workers to connect patients to medications for opioid use disorder, alcohol use disorder and other treatments. The program decreased inpatient utilization by nearly 20%, according to a study published in The New England Journal of Medicine in November. 

Cityblock is targeting continuous refinement and improvement in the program, said Ms. Mehta, including making sure the right patients are identified for the program, and that community health workers are equipped with the training they need. 

The company also plans to "triple-down" on its efforts to help its health plan partners hit quality goals, Ms. Mehta said. One key area of focus is following up with patients who are discharged from the hospital for a mental health condition. 

Cityblock is asking behavioral health specialists to identify when Cityblock patients have been hospitalized and ensure they stay on track with medications and outpatient care. 

"Most rehospitalizations happen after someone is discharged, within the first week. It's a challenge to integrate back into the community after a behavioral health hospitalization, so we want our staff to be there," Ms. Mehta said. 

Value-based care can be a challenge to implement in behavioral health, but Cityblock firmly believes it can address primary care, social needs and behavioral health. 

"I think we're at an inherent advantage, because we can address all of the components of health," Ms. Mehta said. "When you're a behavioral health provider and you're missing the other pieces, it makes it a lot more challenging to contract and create a value-based system that includes everything." 

Leadership buy-in is key to creating a model that can address every component of health, Ms. Mehta said. Cityblock is constantly evaluating programs to make sure they're improving the cost of care, patient engagement, or provider and patient satisfaction. 

"In order to get leadership buy-in, we need to do constant evaluation. Certainly, there's literature that shows that behavioral health interventions will improve physical health. But it's one thing to read it and another to prove it out in practice," Ms. Mehta said. 

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