People with behavioral health conditions along with the physical conditions increase the overall healthcare cost

Sep, 2020 - by CMI

People with behavioral health conditions along with the physical conditions increase the overall healthcare cost

Recently Milliman, Inc. has conducted a study for people with behavioral health conditions in addition to physical health drive high healthcare spending. Although spending on the behavioral health treatment is a small portion of totals spending, while most of the spending is on physical health treatment. These details are revealed from the study conducted by Milliman, Inc. that state data for 21 million commercially insured individuals. The report released by Milliman, Inc. commissioned on behalf of The Path Forward for Mental Health and Substance Use by the Mental Health Treatment and Research Institute LLC, in order to study the overall healthcare cost for the patients with a mental health condition.

This study focused on people with a behavioral health condition and their overall spending on healthcare. The 21 million people that are commercially insured populations, the most expensive 10% of patients accounted for 70% of annual total healthcare costs. Therefore, 10% of the 21 million people contributed 70% of the cost for the 21 million people. In this study, 21 million people belong to the high-cost group and the total healthcare cost per high-cost group patient averaged $41,631.

In this study out of the 21 million population, 57% (1.2 million individuals) also belonged to the high-cost Behavioral Subgroup (BH Group) and this group accounted for 44% of the annual entire healthcare spending of the total 21 million. Moreover, out of the total 21 million population, 27% were in the Behavioral Subgroup Group and it represented 56.5% of annual total healthcare costs for the total population.

Furthermore, the study also reveals that the annual healthcare cost of the Behavioral Subgroup group for physical treatment were 2.8 - 6.2 times higher than the people with no mental health condition. 50% of people in the Behavioral Subgroup Group spent less than $68 of total annual costs for behavioral health treatment; the other 25% spent around $68 to $502 and 4.4% of total annual healthcare costs were for behavioral for the entire population.

This study reveals that a small portion of the high-cost people contributes a significant rise in the total healthcare costs and the majority of these people belong to the Behavioral Subgroup Group. Mostly, costs for mental health treatment accounted for the small fraction of total healthcare costs for these people, and most of them had very little or no spending on treatment for behavioral health conditions. So there is a misconception around the globe that patients with mental health conditions such as schizophrenia or psychosis drive the high cost of healthcare which is not true as they represent a very small portion of the prevalence especially for the commercial population but this also includes other insurance beneficiaries.

Thus, this study shows the need for early identification and treatment for behavioral illness and the key takeaway for health care policy makers is that they should identify this group early and offer some improvement in the healthcare services.