More than one in five patients have a diagnosed behavioral health condition, and they drive about 41% of total healthcare spend, likely due to a combination of comorbid conditions, a new report shows.
The analysis was published Wednesday by the Evernorth Research Institute. It analyzed claims data of 6 million people from 2021 to 2022.
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It found that 87% of those with a behavioral health condition also have one or more medical conditions. These medical conditions can include circulatory disorder, endocrine disorder, musculoskeletal disorder or disease.
“When behavioral conditions go untreated, these comorbid medical conditions worsen, and the ability to function in workplaces, families and communities can be hindered,” the report states. “Moreover, costs for patients with a medical condition and behavioral condition are two to three times higher than for patients without a behavioral condition.”
The report also found that the prevalence of behavioral health conditions rose by 4% from 2021 to 2022. However, the increase in prevalence is different based on the condition. Attention-deficit hyperactivity disorder (ADHD) saw the largest increase, followed by personality disorder and autism spectrum disorder.
These findings come at a time when more than half of adults with a behavioral health condition do not gain treatment, according to Mental Health America.
“Improving care begins with recognizing the long and chaotic road to finding effective treatment,” said Dr. Doug Nemecek, chief medical officer for behavioral health quality, integration, and clinical operations at Evernorth, in a news release. “Finding a therapist who has demonstrated effective treatment for someone’s specific behavioral health condition is not easy. For one, the demand for care is much higher than the supply of providers, which often leads to delays in care, poor patient outcomes, and higher health care costs.”
The report identified actions for health plans looking to improve behavioral health access. The first is recognizing the challenges to starting care. It can be difficult finding the right provider for a patient’s needs. On top of that, there are significant workforce shortages that can lead to wait times.
It’s also important to know the different “personas” of behavioral health patients. Evernorth’s research showed four personas:
- Willing engagers, who receive behavioral health treatment from a behavioral health provider (33% of patients)
- Self-directed seekers, who receive behavioral health treatment from a medical provider (18% of patients)
- Complex copers, who receive treatment for a physical health condition, but their behavioral health condition surfaces frequently (10% of patients)
- Silent sufferers, who receive treatment for a physical health condition and their behavioral health condition surfaces only one time in a medical setting. This group also includes those who have not been diagnosed with a behavioral health condition (39% of patients)
Based on these personas, plans need to build a “robust ecosystem” to make it easier to receive care, the report showed. This includes earlier identification, assessments on patients, matching patients to the right providers and measuring outcomes.
Photo: SIphotography, Getty Images
