Can a health insurer help break the recidivism cycle?

Individuals who have served time in prison often find it difficult to navigate the expectations placed on them once they are released back into society. After living lives of strictly regimented schedules and activities – often for years – reentering a world of uncertainty and relative freedom can be more than daunting. Falling back into bad habits or behavioral patterns can seem easier than forging a new path.

The Bureau of Justice Statistics estimates that, across the U.S., 68 percent of prisoners are arrested again within three years, 79 percent within six years and 83 percent within nine years. It is estimated that the U.S. spent over $270 billion for the criminal justice system, including maintaining prisons, in 2016.

Can a health insurer help break the recidivism cycle?

Considering the cost in resources, time, money, and human potential that is lost to recidivism, states are trying to improve re-entry programs for offenders being paroled or released. In Nevada, for instance, officials recognized the need to remove key barriers faced by parolees trying to comply with parole requirements while reintegrating into society, and decided to supplement its already robust re-entry program with additional support services. The Department of Corrections looked for a partner that understood how to integrate medical and behavioral health, successfully address the unique needs of vulnerable, high-risk populations, and had strong data management resources and experience. 

That is how Anthem Blue Cross and Blue Shield of Nevada (Anthem), working with the Well Care Services Group (Well Care) – a provider partner that offers wrap around services such housing coordination, transportation to community and social services resources as well as integrated primary care, therapy for mental illness and medication management – collaborated with state officials to develop Pathways Forward.

How does it work?

As an inmate nears his or her release date, Anthem representatives meet with the individuals to explain benefits that are available through Medicaid and Pathways Forward, such as integrated medical and behavioral health services, counseling, housing, employment training, family reunification services and more. Individuals who are to be released and are eligible to receive Medicaid benefits, can choose to become an Anthem Blue Cross and Blue Shield member and enroll in the Pathways Forward program. Once enrolled, they can take advantage of any services they need to succeed, including supportive housing, substance abuse counseling, anger management, chronic disease management, transportation and financial literacy education.

After release, the parolee is assigned to a case manager who provides a holistic assessment of his or her physical and mental health as well as the conditions of their parole, their goals, social needs and the challenges they face in meeting those goals. Supports offered can include transportation to meetings with their parole officers, enrolling in GED classes, obtaining the medicine they need to manage chronic conditions or simply helping individuals with accessing services available to them, such as obtaining a government-sponsored phone. The case manager connects parolees to the resources they need to ensure a successful transition back into the workforce, society and their families. The program also places great emphasis on helping individuals improve and maintain their health through scheduled health checks, care coordination and the needed encouragement to follow doctor’s orders. As long as the individuals are meeting the requirements of their parole and the Pathways Forward program – searching for or obtaining a job and attempting to reconnect with family – they can stay in the program until they are self-sufficient. For most, this usually takes three to six months.

Is it helping?

While Pathways Forward is still in its infancy, the program is already making a difference, and has helped 43 people stay out of prison and get back on their feet. Consider one participant, who was released from a year’s stint in prison with nothing more than the clothes on his back.

“He had no job, no home and no real prospects. Even worse – he had lost contact with the center of his world – his young son,” said Lisa Bogard, Anthem director of state Medicaid operations. “Even though he really wanted to be self-sufficient and get his life back on track, he was already facing homelessness and inability to meet the conditions of his parole, which could result in additional penalties and send him back to prison. “

Because he enrolled with Anthem and chose to participate in the Pathways Forward program, he left prison and had his own apartment, food to eat and clothes to wear waiting for him. Beyond these basic necessities, Anthem also helped him find work and enroll in employment training and certification classes. He quickly found work, and soon, he expects to graduate from training to be a licensed truck driver. He is also receiving therapy and health care case management at no additional cost to him, which has allowed him to meet his parole requirements, take control of his health and improve his life.

What has made the biggest impact however, is the program’s reunification services, which has reunited him with the son he had to give up when he went to prison.