The matchmaker for behavioral health program, a Premera Blue Cross initiative to connect members with mental health professionals, has helped thousands of members since launching in 2023, says David Condon, Premera’s vice president for Eastern Washington.

In 2024, Premera’s matchmaker service provided 2,700 members with curated lists of in-network providers accepting patients to members seeking mental health services, up from 800 in 2023, Condon says. He claims that 70% of members who received a matchmaker list went on to meet with a behavioral health specialist. 

“It really has a great application and high utilization rate,” Condon says of the program. “Mental health is part of who we are and the holistic approach we take … especially for managing chronic conditions.”

To use the program, members can call the back of their membership card and be connected to the service. The member will answer a couple of short questions to help match or recommend them to an in-network provider accepting new patients.

Across the country, communities are facing a shortage in mental health providers, an issue that was present before the pandemic and has since only grown larger, Condon says. Spokane County fares a bit better than other parts of Eastern Washington, he says, however, it is still a major issue facing Premera Blue Cross across the state and across its entire member network.

Without the matchmaker service, it typically would take Premera members between eight and 11 phone calls to cultivate a shortlist of in-network providers, equaling about seven to 10 hours over a few weeks, Condon says. 

“And that, in itself, just adds to the anxiety and depression over just finding someone to help them,” he says. “That was at the genesis of what created this service ... focusing on where (members) were getting frustrated and making things simple and easy for them.”

Addressing the mental health issues of employees is an important task for employers to focus upon, says Condon, referencing how days lost for employees who are in mental distress cost employers thousands of dollars each year.

According to a report by Gallup, workers with poor mental health are estimated to have nearly 12 unplanned days of absences annually, compared with 2.5 days for all other workers. Across the U.S. workforce, absenteeism is estimated to cost the economy $47.6 billion annually in lost productivity.

“To have (employees) connected to a therapist that’s right for them, I think, is the right thing to do for the employee, and quite frankly, it’s the right thing to do for your bottom line,” Condon says.

Premera Blue Cross, which is headquartered in Mountlake Terrace, Washington, launched its matchmaker for behavioral health program in 2023 to reduce barriers for people experiencing mental health conditions and substance abuse disorders. To support the matchmaker service, Premera Blue Cross expanded its provider network and continues to support the integration of behavioral health services into primary care clinics, Condon says.

Amanda Lansford, senior external communications manager for Premera Blue Cross, says the matchmaker program is available to members who have a fully insured plan that includes small group and association plans. Self-funded plans have the option to add on the service to their coverage, Lansford says. The matchmaker team can provide access to adults and children living anywhere in the country, but the provider needs to be licensed in the state where the member lives.

“For example, if someone lives in a rural part of Washington where they might have fewer in-person providers who meet their needs, they can be matched with a Spokane-based provider that can see them virtually,” Lansford says.

Since the program started, the most requested service type is talk therapy, followed by medication management, and psychological testing. Data on the most frequent conditions experienced by members includes anxiety, depression, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, and bipolar disorder, Lansford says.

Research from the University of Washington School of Medicine finds that the Evergreen State ranks among the lowest in the nation in serving people with mental health challenges, with nearly half of the state’s 39 counties devoid of a single working psychiatrist. A study from the Washington Department of Health shows one mental health provider for every 360 people in Washington state. Depending on the county, the ratio of behavioral health providers ranges from 1 for every 262 people to 1 for every 3,378 persons.

 Condon says Premera Blue Cross has been focused on making significant investments that support a holistic approach to mental health care since before the onset of the COVID-19, during which demand for mental health services reached a peak.

In 2019, the health care plan provider donated $10 million to the University of Washington School of Medicine’s Center for Advancing Integrated Mental Health Solutions to support the incorporation of collaborative care in rural clinics across Washington and Alaska.

The collaborative care model is an approach in which behavioral health is embedded into a primary care setting that facilitates collaboration between medical and behavioral health providers to work together with patients as a team. The integrated model includes regular outreach to patients, improvement measures, and changes to treatment.

Lansford says 18 clinics across rural Washington and Alaska received funding to implement the collaborative health care model. Those clinics include Federally Qualified Health Care Centers, critical access hospitals, rural primary care clinics, and Indian Health Services. In Spokane, CHAS North Country clinic in Deer Park was part of this program.

Premera Blue Cross also partnered with the Kinwell Medical Group, a physician-owned practice, to help address the growing primary care crisis, Condon says. Kinwell, also integrates behavioral health practitioners into their practice, he says.

“Even as Kinwell was launched … it was seen as critical in having that integrated behavioral health experience right in the primary care setting,” Condon says.