Spending on Behavioral Health Treatment Lags Among Patients with Co-Occurring Conditions

A study released by Milliman illustrates a sizable disconnect between the degree to which patients with behavioral health conditions are driving total healthcare costs in the U.S., while spending on behavioral health treatment remains comparatively slim.

Milliman studied 2017 claims data for 21 million commercially insured individuals between the ages of 2 and 64 across all 50 states and Washington, D.C. The study was conducted on behalf of The Path Forward for Mental Health and Substance Use, a national behavioral health initiative, and was funded by the Mental Health Treatment and Research Institute, a subsidiary of the Bowman Foundation.

Among the key findings:

• The most expensive 10% of patients studied accounted for 70% of total annual healthcare costs, averaging $41,631 per patient vs. $1,695 per patient in the remaining 90% of the patient population.
• 27% of the 21 million total patients studied had a behavioral health condition. That behavioral health group accounted for 56.5% of total annual healthcare costs.
• 75% of patients in the behavioral health group had less than $502 in spending on behavioral health treatment, with 50% having less than $68 in behavioral health treatment for the year. Just 4.4% of total healthcare spending went toward behavioral health treatment.

Henry Harbin, MD, adviser to The Path Forward partners, said in a news release that the findings of the study were “astonishing.”

“This is a tragedy,” Harbin said in the release. “And now we know this population accounts for more than half of our total healthcare spending. Tremendous savings and improved outcomes are achievable if these people are identified early and provided with prompt evidence-based behavioral treatment.”

In response to the disparities identified in the research, the Path Forward recommended five reforms for employers, health insurers and providers:

• Improve in-network access to behavioral health specialists
• Expand screening and testing for mental health and substance use disorders
• Expand integration of behavioral health into primary care
• Maintain recent gains in the use of telehealth services with an establishment of standards to support populations with disparate needs, capabilities and access to tech
• Ensure mental health parity compliance

The complete report is available on the Milliman website.