Behavioral Health Service Navigation Program is Transforming the Way Members Access Behavioral Health Care

Harvard Pilgrim Health Care members report high satisfaction rate,
with wait times cut significantly

CANTON, Mass., March 18, 2025 /PRNewswire/ -- Harvard Pilgrim Health Care, a Point32Health company, is improving members' access to behavioral health care with high satisfaction rates and significantly reduced wait times through its Behavioral Health Service Navigation program. The program launched in 2024 and is available to Harvard Pilgrim Health Care and Tufts Health Plan members.

An October 2024 report found that in 2023 there was a 40 percent increase in behavioral health utilization in the United States compared to pre-Covid levels.  For many, seeking behavioral health services is often met with frustration in finding a behavioral health provider and lengthy wait times for an appointment.  The Behavioral Health Service Navigation program was created to address those issues by providing enhanced personalized support through a service navigator.  The service navigator not only helps members find a provider but assists in scheduling timely appointments and follows-up with the member to ensure they were satisfied with the care they received.

"Our Behavioral Health Service Navigation program is a cornerstone to our whole-person care approach," said Jake Biscoglio, president of commercial business for Harvard Pilgrim Health Care.  "Unlike many health insurers whose navigation programs simply provide members with a list of area providers, our program takes a hands-on personal approach. It's unique in the health insurance industry as it provides members with personalized solutions that close gaps in their behavioral health care journey and has the potential to improve health outcomes."

Members seeking a behavioral health provider are assigned a locally based, dedicated service navigator. The service navigator ensures the behavioral health provider meets the members' individual needs including language, gender preference and behavioral health specialty, and follows up with members to ensure they were satisfied with their provider and arranges additional appointments with other providers if necessary. Service navigators can also connect members with the organization's Community Health Worker team, which assists members with such critical needs as transportation, housing and food insecurity. 

Success highlights to date of the Behavioral Health Servicer Navigation program include:

• In most cases, service navigators can assist members in securing a behavioral health appointment within a week from when the member is connected to the program, depending upon the specialty need or appointment format. Studies have shown in-person mental health visits can take up to 60 days, and telehealth visits can take more than 40 days to schedule.
• If a Harvard Pilgrim Health Care member is open to a telehealth appointment, the service navigator can obtain an appointment in real time during the first call with the member.  
• Harvard Pilgrim Health Care's behavioral health provider network has grown by more than 30,000 providers in the past year.
• 99 percent of Harvard Pilgrim Health Care commercial members enrolled in the program were satisfied with their behavioral health provider.

"Access to behavioral health services remains a challenge both locally and nationally due to increased consumer demand," said Bill Harlan, vice president of behavioral health for Point32Health. "While new providers are added to our network every day, we recognize the opportunity to help connect our members with the right services that meet their treatment needs and preferences. Our program has seen overwhelming success, thanks in large part to our local team and the neighbor-helping-neighbor approach that has been instrumental in our ability to help."

To access the service, eligible members can call the Integrated Member Services line on their health plan identification card.  The Behavioral Health Service Navigation program is an integrated insourced approach to behavioral health care, enabling teams such as Member Services, Service Navigators, Care Management and Community Health Workers to better coordinate a member's overall care. 

About Point32Health
Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone, regardless of background or circumstances.

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SOURCE Point32Health