As healthcare providers grapple with soaring demand for behavioral healthcare, a new analysis by Cigna’s health services subsidiary found that access to outpatient mental health services can have a significant impact on an individual’s cost of care over two years.
Evernorth Behavioral Health found that getting outpatient behavioral healthcare could reduce a person’s total cost of care by $1,107 to $3,109 over two years. For example, having timely access to mental healthcare can lead to fewer emergency department visits and inpatient hospitalizations, according to the study. People needed to have at least three visits for it to have a significant impact on the cost of care.
The analysis was conducted before the Covid-19 pandemic. Evernorth looked at four years of medical, behavioral and pharmacy claims data from January of 2016 through March of 2020, encompassing about 275,000 patients.
The analysis included people covered by a commercial health plan, individual plan or family health plan, but did not include older patients covered by Medicare. It specifically focused on people who had been newly diagnosed with a behavioral health condition, such as anxiety, depression or substance use disorder.
Roughly 32% of these patients received outpatient behavioral health treatment, including individual counseling, group counseling or therapy, sometimes in conjunction with medication. A larger portion, 68%, did not receive any treatment, including medication.
“Our research uncovered opportunities to help more people get the behavioral care they need to improve their health, well-being and productivity, while also reducing costs,” Evernorth Behavioral Health President Eva Borden said in a news release. “This is critically important as we work to drive improved affordability for plan sponsors.”
A recent survey by the Kaiser Family Foundation found that employers have revisited their mental health benefits since the start of the pandemic, with some adding access to telehealth visits or employee assistance programs. Insurers have also looked to telehealth as an avenue for access — earlier this year, Cigna purchased MDLive, after launching a behavioral-health pilot with the company in 2020.
However, many patients are still grappling with coverage gaps and long waits for treatment, according to a report released by the GAO earlier this year. A group of senators is taking a closer look long-standing parity laws, which require insurers to provide the same level of coverage for mental healthcare as for physical healthcare, and some states are adding their own enforcement of the law. They’re also taking a closer look at denied claims, workforce shortages and racial inequality.
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