Patients with depression and associated mood disorders have the highest medical costs, even when compared risk factors such as obesity, high blood sugar and high blood pressure. A recent study using the health insurance claims determined that members with depression had a 48% higher health care spend. Many more studies indicate that depression costs billions in lost productivity in the workplace and significant related disability costs. Researchers agree that the costs associated with mood disorders and mental health issues are greatly unreported and underestimated. Therefore, the costs associated with mental health related issues are much higher than reported.
Furthermore, consider 74% percent of all healthcare costs result from four health conditions: cardiovascular disease, cancer, diabetes and obesity. Eighty percent of cardiovascular disease and diabetes cases are preventable and 90% of obesity cases can be prevented. The collaboration between medical providers and behavioral health providers to help motivate and inspire patients to stay in engaged with their wellness plans has profound implications for medical costs savings.
It is important for behavioral health providers to know that the surefire analytic departments at insurance companies, government agencies and brokerage firms that advise employers on health care costs, are recognizing these FACTS. Employers are advised to screen workers for high-risk behaviors, and to treat them proactively. However, there are also suggestions toward screening out perspective employees with these risk factors; although unethical and illegal.
Integration of Medical and Behavioral Practices
Behavioral Health providers have an opportunity to work with insurance companies, employers and Accountable Care Organizations (ACO’s) to treat more than mental health disorders and help engage members/patients to motivate and inspire them to attend to their health and well-being. Behavioral health professionals may be best equipped to help members manage their health and wellness goals. The collaboration between patients and medical and behavioral health professionals will result in increased well being and lower medical costs.
The Behavioral and Medical Providers
The formula for using behavioral health providers to inspire and motivate patients to engage in their wellness plans is not simple. Simply co-locating behavioral health providers within primary care or patient centered medical homes is NOT the necessarily the solution. The integration of medical and behavioral health practices is latent with challenges.
1. The concept of the Integration of medical and behavioral practices is a new paradigm to many providers. A full endorsement from the providers and buy in from the patient is required.
2. For most practices, significant training and preparation is required for a successful implementation and execution.
3. Even if providers understand the new paradigm conceptually, the implementation, execution, process, functionality and reimbursement are essential components to a successful increase in patient well-being and significant medical cost reduction.
4. The right medical and behavioral providers and patients are required. The interactive dynamic teamwork between the medical and behavioral providers is important. The required collaborative teamwork can be accomplished by properly selecting the team members. Also providers need to develop an agreed formula or strategy for identifying patients that will befit from an integrated model.
5. Organizations must have the necessary analytical resources to measure the outcomes of an integrated system. The effectiveness of provider and clinical outcomes of patients needs to be measured.
6. Finally, an integrated medical behavioral model that is designed to increase the well-being of patients and reduce medical costs must be part of a shared savings or incentive model for providers.
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