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Report: Behavioral Health Accounts for 41% of Overall Health Spend
A report released recently by Evernorth, the health services division of Cigna, has found that 22% of US adults have been diagnosed with a behavioral health condition, but account for 41% of the nation’s healthcare spending. Moreover, just half of adults with a behavioral health condition receive treatment.
>> READ Evernorth’s “Putting Behavioral Health Top of Mind” report
Demand for care, meanwhile, continues to escalate. Evernorth reported that the prevalence of behavioral health conditions grew by 4% in 2022, based on an analysis of anonymized and aggregated claims data for 6 million individuals. Prevalence varied by condition, with attention-deficit hyperactivity disorder (ADHD), personality disorder, and autism spectrum disorder having the largest percentage increases year-over-year.
The report also found that 87% of patients with a behavioral health condition also have at least 1 co-occurring medical condition, and that costs for patients with co-occurring medical and behavioral conditions are 2 to 3 times higher than for patients without a behavioral condition.
Conversely, Evernorth said its analysis showed that effective behavioral health treatment can reduce overall healthcare spending. As an example, Evernorth noted that patients with type II diabetes and major depressive disorder who receive behavioral healthcare services have a medical savings of $1,649 per member per year compared to those who receive insufficient behavioral health services.
“The mind and body are intrinsically connected,” Eva Borden, Evernorth’s president of behavioral health, said in a news release. “It’s something that plan sponsors must take into account. Employee mental health is being challenged like it never has been before, and this impacts the workplace.
“Companies that expand their definition of health and wellbeing in the workforce to encompass both physical and mental health, and are able to provide holistic support through benefits and employee well-being programs, stand to win in the end.”
Based on its analysis, Evernorth concluded its report with the following 3 insights for behavioral healthcare stakeholders to improve outcomes:
Recognize the challenging road to finding effective treatment. On average, it takes patients 11 years after the onset of mental health symptoms to seek treatment, with delays ranging from 6 to 8 years for patients with mood disorders to between 9 and 23 years for those with anxiety disorders. Reasons for delay can include underdiagnosis, stigma, and health equity disparities. For more than 150 million Americans, living in areas designated as having a behavioral healthcare provider shortage is also a challenge.
Understand that seeking behavioral healthcare services is a highly personal journey. Evernorth defined the following 4 personas to categorize behavioral healthcare patients:
- Willing engagers (33% of those with behavioral health conditions): Individuals receiving treatment for a behavioral health condition from a behavioral health provider.
- Self-directed seekers (18%): Patients seeking treatment from a medical provider for a behavioral health condition.
- Complex copers (10%): Patients receiving treatment primarily for a physical health condition and have a behavioral health condition surface multiple times.
- Silent sufferers (39%): Patients receiving treatment for a physical health condition and having a behavioral health condition surface just once in a medical setting. This persona includes those who have not yet been diagnosed.
Building a robust ecosystem is critical for guiding care and achieving measurable outcomes. Creating opportunities for patients to make seamless connections with behavioral healthcare services requires the following 4 steps:
- Early identification and engagement. Behavioral healthcare needs can be identified by patients themselves, by primary care providers, by engaging with online resources, or by health plans leveraging artificial intelligence and machine learning, which can predict patient needs based on health history.
- Assessment and recommendation. Providers can develop precise care pathways that meet patient needs and improve cost and quality outcomes by leveraging data, screening tools, and machine learning techniques.
- Right care matching. Matching patients with the right provider can also improve clinical and quality outcomes. Patients who stay with their provider engage in their second visit 35 days faster on average, according to data cited by Evernorth.
- Outcomes measurement. Measurement for all stakeholders practically informs care and demonstrates a return on investment. Among the metrics Evernorth recommended for consideration were the following: time to care, medication adherence, patient-reported quality of life, and total cost of care.
References
Putting Behavioral Health Top of Mind. Evernorth Health Services; 2023.
