Evernorth: Behavioral Health’s Impact on Physical Health Is ‘Something Plan Sponsors Cannot Ignore’

The majority of patients with behavioral health conditions also have one or more medical comorbidities.

And this can drive up the cost of care for patients with a behavioral health diagnosis. That’s according to a new report by Cigna’s health service division, Evernorth. The report found that 22% of patients have a diagnosed behavioral health condition, and they account for 41% of the total health care spend. 

Generally, if behavioral health conditions are untreated, patients’ physical health conditions worsen, the report notes. That’s why it’s essential to prioritize holistic care, according to Dr. Douglas Nemecek, chief medical officer of behavioral health at Evernorth.

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“We found that 87% of individuals with a mental health condition had at least one [physical] condition in addition [to that],” Nemecek wrote in an email to Behavioral Health Business. “It’s something plan sponsors cannot ignore. Employee mental health is being challenged like it never has been before, and this impacts the workplace.”

Photo credit: Evernorth

In turn, companies need to “expand their definition of health and well-being in the workforce” to encompass both physical and mental health, providing holistic support through benefits and employee well-being programs, he said.

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There has also been an increase in the prevalence of behavioral health conditions from 2021 to 2022. Diagnosis of attention deficit and hyperactivity, personality disorder, and autism spectrum disorder have all increased by more than 10%. Additionally, eating disorder and anxiety disorder prevalence are both up by more than 5%, according to the Evernorth report.

Still, many patients are not in treatment for their mental health condition.

Half of patients with a behavioral health diagnosis are not in active treatment, according to the report.

“As a society, we’ve made tremendous progress normalizing the conversation around mental health, but stigma still exists,” Nemecek said. “This can lead to difficulties seeking help and getting diagnosed. Access to quality behavioral health care and finding an appropriate and effective patient-provider match are also key challenges. This latest research also reinforces the need for patients to be connected to the full spectrum of care and support.”

Photo credit: Evernorth

When it comes to finding the right behavioral health provider, match and long wait times are often barriers to care, according to the report. It takes, on average, 11 years from the onset of behavioral health symptoms to the start of treatment.

But new advancements in technology could help in the future.

“Digital behavioral health solutions, including virtual care and app-based solutions, can help engage patients early and regularly to help them manage their condition,” Nemecek said. “While some individuals will continue to do better with in-person care, digital and virtual solutions can provide expanded access and support for patients with behavioral health needs, bringing simple and convenient care to more people.”

Including primary care providers in the behavioral health conversation is also a key to combating the mental health crisis, Nemecek noted.

Specifically, primary care providers are crucial to screening for behavioral health conditions and supporting patients as they navigate care.

“We must equip primary care providers with training, resources and tools to best support their patients who need behavioral health care,” Nemecek said.

Photo credit: Evernorth

If patients’ behavioral health needs are treated, it could be good for their overall health and significantly drive down costs.

“Engaging individuals in outpatient behavioral health care can reduce medical spend by up to $2,565 per member over the 15 months after their initial diagnosis, which underscores the importance in finding the right provider-to-patient match,” Nemecek said. “In addition, patients need a fully integrated, robust ecosystem of care with early identification and personalized care pathways, and by aligning health plans and providers around measurement and quality care, not only will individuals have improved clinical outcomes, but we will also see improved affordability.”

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