CareFirst BlueCross BlueShield and Navigator Announce Partnership to Improve Access to Drug and Alcohol Treatment
Substance use disorder treatment program will leverage technology to connect members to care
Baltimore, MD/Washington, D.C. – CareFirst BlueCross BlueShield (CareFirst), the largest not-for-profit health plan in the mid-Atlantic region, and Navigator Healthcare, Inc., an independent healthcare service for those affected by drug and alcohol use, today announced a partnership to improve access for substance use disorder (SUD) treatment for CareFirst members and their families.
According to the Substance Abuse and Mental Health Services Administration, in 2021 around 46.3 million people across the United States experienced a SUD, with the highest rates of severity among individuals who used cocaine and methamphetamine. Of those 46.3 million people, it was found that 43.7 million people needed SUD treatment yet only 3% of individuals received any treatment for recovery. SUD cases have also increased due to the unprecedented impacts that the coronavirus (COVID-19) pandemic has had on mental and behavioral health, according to The Kaiser Family Foundation.
“Individuals struggling with alcohol and/or drugs generally do not know about the treatment and recovery options available to them through their health benefit plan,” said Brian Wheeler, Vice President of Provider Collaboration and Network Transformation for CareFirst. “When people in need don’t know their options for support, they often either make a poor choice or worse, decide not to engage in recovery. Through Navigator’s facilitation and support program, our members will be connected with an expert to support them through their care journey. This human connection is expected to improve outcomes as someone supporting the patient across time and care settings can increase engagement and retention in programs leading to more success in managing addiction.”
Through the partnership with Navigator, CareFirst Members seeking evaluation and treatment for SUD have access to 24/7/365 support by calling the mental health and substance use phone number on the back of their insurance card. The number connects each individual with a licensed behavioral health clinician with expertise in SUD who helps them understand treatment options and schedules an evaluation on demand in a same-day or next-day timeframe. Once placed in a treatment program, Navigator follows and supports the Member for up to 6 months through any transitions of care and help them troubleshoot rough patches on the way to recovery.
Deb Adler, CEO and Founder of Navigator said, “It is not possible to overstate the ‘entry to care crisis’ for those living with SUD. We never lose sight of the people behind the statistics: 29.5 million people have an alcohol use disorder (AUD) which translates to high rates of human suffering. And AUD is still the leading medical cost driver among all SUD conditions for payers. We built Navigator to be an effective solution not only to address these rising statistics and associated costs across all SUD conditions but also to instill hope for individuals and their families with a confidential and trusted clinician available around the clock to navigate these complex and challenging waters. We are pleased to be working with CareFirst members and their families, offering knowledge that empowers individuals to quickly start and stay on their journey to recovery. With CareFirst, we will support the broader healthcare delivery system --PCPs, health systems, specialty providers— improving entry to services and sustained engagement in treatment.”
CareFirst Commercial and Medicare Advantage Members, regardless of their location in the United States, will be able to use this service. Navigator will be fully operational and ready to connect people with providers in the coming months. Additionally, Navigator is accessible for CareFirst members seeking help for a loved one needing SUD treatment.
“It is not just Members who have trouble accessing treatment. Often family members, primary care physicians, emergency department staff or law enforcement are in a position to advocate for a person in distress, but they don’t know how to help,” said Wheeler. “These key stakeholders will also be able to use this hotline to help connect people to the care they need.”
CareFirst’s partnership with Navigator is one of the many ways the organization is working to address the mental and behavioral health crisis in the mid-Atlantic region. Most recently, CareFirst distributed nearly $8 million in grants to community-based health organizations focused on eliminating barriers to services and expanding the behavioral health workforce.
About CareFirst BlueCross BlueShield
In its 85th year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit healthcare company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to 3.6 million individuals and employers in Maryland, the District of Columbia and Northern Virginia. In 2022, CareFirst invested $24.1 million to improve overall health, and increase the accessibility, affordability, safety and quality of healthcare throughout its market areas. To learn more about CareFirst BlueCross BlueShield, visit our website at www.carefirst.com and our transforming healthcare page at www.carefirst.com/transformation, or follow us on Facebook, Twitter, LinkedIn or Instagram.
About Navigator
Navigator Healthcare, Inc. is a solution built with today’s health system, consumers, and payers in mind. Navigator strengthens member access and engagement in evidence-based substance use services which, in turn, increases treatment retention and improves member outcomes. With 24/7 availability, Navigator deploys a number of engagement strategies including motivational interviewing, rapid entry to care, and follow-up care coordination services. Navigator’s human solution leverages technology to coordinate directly with treating providers to schedule appointments same day or next day and support real-time reporting of member engagement with clinically effective, in-network care. Working across all lines of business: commercial, Medicaid, and Medicare, Navigator integrates seamlessly with member mobile applications, call center and care specialists, and is the "easy button" for PCPs and other medical providers to facilitate fast access to evidence-based substance use disorder treatment. For more information, go to www.navigator.health or follow us LinkedIn.