Peer Workers, Better Outcomes

ONE ON ONE –

April 3, 2021 – Peers are a growing workforce in behavioral health, with an estimated 30,000 or so workers employed nationwide. Additionally, over three-quarters of states reimburse peer services through Medicaid, but not all payers are as progressive.

Still, she stressed their importance to providers in the space.

“These are people with lived experience [dealing] with substance use and mental health,” Knutson said. “Bring in peers to help align with people [and meet] them in the community. These are … things that we can do to help improve the access and … the quality of care ultimately leading to better health outcomes and costs.”

Various published studies have made the case for the use of peers in behavioral health care, and Knutson noted that peer workers could be a novel way to assist health care systems burdened by limited resources. One reason for the lack of resources and personnel in behavioral health is the low reimbursement rates providers typically are paid on a fee-for-services basis.

“I would rather go to… a global payment model where we say, ‘This is the amount of money [providers] have … to deliver all the care that’s needed,’” Knutson said. “How can a provider deliver these services in a way to where they’re maximizing the resources and maximizing those health outcomes? That’s when you see those investments in peer support.”

Knutson also noted that the behavioral health care industry, in its move toward value-based care, needs to develop better measurement tools for patient outcomes.

“Right now, the true health outcome measures in behavioral health are the person-reported health outcomes [and] the symptom rating scales — so like the PHQ-9 for depression, for example — but that’s really limited,” she said. “You’re asking somebody to think back over the last two to four weeks and … measure their symptoms. If we had ways to measure outcomes in real time and symptoms in real time — even through passive devices — it would be a true game changer.”