Behavioral Health Care Significantly Lowers Medical Care Costs

New analysis finds that even the lowest level of behavioral health treatment can make a big impact on total health care spend.

Before the pandemic, the CDC released data showing that only 17 percent of U.S. adults were in optimal mental health. This alarming statistic revealed enormous opportunity for the vast majority of our population to improve their mental health and well-being. Then COVID-19 upended life, irreversibly accelerating the need for mental health care, while decreasing the stigma associated with getting care. As a result, more people are seeking the help and treatment they need.

We know obtaining care is likely to improve mental health and there is growing recognition it will also improve physical health, but can we prove that the impact of behavioral health care on physical health is strong enough to reduce total medical costs? The answer is “yes.”

This first-of-its-kind analysis by Evernorth of approximately 275,000 customers found that people diagnosed with a behavioral health condition, such as anxiety, depression, or substance use disorder, who receive behavioral outpatient care had lower total health care costs by up to $1,377 per person in the first year compared to those who didn’t. Not only that, the savings impact was sustainable over time with a two-year cost reduction of up to $3,109 per person.

Costs decreased because individuals utilized fewer medical services, including expensive emergency department visits and inpatient hospital stays. These savings more than offset the costs of behavioral outpatient care, and means that even the lowest level of treatment can make a significant impact by helping people feel better, mitigating health care costs, and driving improved system-wide affordability. Higher levels of behavioral health treatment include intensive outpatient care, partial hospitalization and inpatient care.

The findings are ground-breaking, and demonstrate there is much work to be done to help people throughout a lifelong mental health journey. Unfortunately, most people do not get the mental health treatment they need until they’re experiencing a crisis. Providing access to behavioral outpatient care is a vital resource that allows individuals to explore symptoms that could lead to mental health distress, enact new thought patterns, and learn adaptive coping skills over time.

We are acting on these findings, in partnership with plan sponsors, by engaging the members they serve and guiding them to the behavioral health care that best meets their needs – whether that is in-person, virtual, or digital. There is a tremendous opportunity to connect more individuals to mental health support earlier and more often which, in turn, will lead to better overall health and well-being and lower total medical spend.

Learn more about how total cost of care significantly decreases when people get the behavioral health care they need.

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Evernorth Behavioral Health
Evernorth’s data-informed approach to behavioral health provides personalized and customized care across the entire continuum for the populations we serve. These solutions predict emerging health needs, close gaps in care, and drive cost savings—all while empowering whole person and whole family health.

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