Catalyst for Payment Reform

San Francisco tackles mental health care access in the midst of COVID-19

San Francisco tackles mental health care access in the midst of COVID-19

San Francisco Health Service System (SFHSS) purchases health benefits for over 120,000 City and County employees, retirees and their dependents residing in the Bay Area, all across the United States and around the world. As a public-sector employer, SFHSS strives to provide affordable access to high-quality care and enhance the well-being of employees, retirees, and their families. It operates in a region with difficult market conditions: as a result of provider consolidation, the prices for health procedures in Northern California are 20-30% more expensive than in Southern California after adjusting for local cost of living.

SFHSS has implemented innovative solutions as part of its comprehensive health benefits strategy to promote competition and improve plan member satisfaction. For example, the purchaser deployed an Accountable Care Organization (ACO) strategy paired with an HMO benefit design. SFHSS shared lessons learned from this program during CPR’s 2018 webinar, “Communicating High-Value Health Care to Employees.”

The onset of COVID-19 brought new challenges to SFHSS in its mission to preserve and improve sustainable, high quality health benefits. San Francisco has consistently maintained a precautionary approach throughout the pandemic, allowing it to “bend the curve” at the outset of the pandemic. Yet even with its lower COVID-19 case rate, the combination of this summer’s racial justice protests and the massive workplace shifts for the City’s frontline responders caused an uptick in mental health needs across SFHSS’ covered population. SFHSS worked quickly to expand access to mental health care. To learn more about how SFHSS turned on a dime to quickly meet the mental health needs of members, watch the recording of SFHSS’s presentation during CPR’s Fall 2020 Innovative Purchaser Series.

One Mind COVID-19 Impact Timeline
A graph from One Mind depicting psychological trauma, mental illness, economic injury, and burnout as  as a second wave of impact (full turquoise line) from COVID-19.

This shift to increasing mental health awareness and needs during these trying times is not unique to San Francisco. Across the United States, employers are seeing increased mental health demands for conditions like anxiety and depression and symptoms of negativity and stress. Furthermore, the San Francisco Chronicle reported that more than 50% of over 1000 workers surveyed said their companies could be doing more to bolster their mental and overall health during the pandemic. Working from home, limited social activities, increased household labor, and political stressors add to the burden of a global and national pandemic. Employers have never faced a more urgent need to provide accessible mental health care that for the diverse needs of their covered populations.

CPR is helping employers ideate on solutions and resources around mental health in our upcoming Collaborative. We will also be conducting a concurrent vendor evaluation with results to be published in Spring 2021. If your organization offers mental health solutions to self-funded employers, contact us to see if you’re eligible to participate.  Both of these efforts will build off of CPR’s previous work uncovering the challenges and opportunities in the mental health marketplace. Other organizations, like Mental Health First Aid, provide trainings on approaching mental health in the workplace, for both managers and employees alike. The first step is to breakdown the stigma around mental health that may be preventing access to care, and, for that, there is no better time than the present.

Photo of San Francisco waterfront by Meriç Dağlı on Unsplash.

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