The Case of Rising Behavioral Health Claims

The Case of Rising Behavioral Health Claims:

Identifying a mental health and wellness program that would be valued by employees and reduce the employer’s costs.

The Investigation: Searching for a Better Mental Health Support Program

An AssuredPartners client was experiencing a troubling increase in the number of employee mental health claims being filed with its medical plan. While supporting employee mental health had always been a topic of discussion between the client and the AssuredPartners benefits team, after the client shared details of two distressing events that had recently occurred at two separate company locations, it became clear that the client wanted all employees to have easy and affordable access to professional counseling and psychiatric help whenever they needed it. At the time, the leadership team did not feel its traditional medical plan could provide the robust mental health services they required and asked us to assist in identifying a more effective program.

When taking on a project like this, our first step is to evaluate the data - particularly year-over-year claims information - to gain a deeper understanding of the situation. A few of the red flags that emerged as part of this initial analysis included*:

• An 8.5% rise in mental health office visit claims.
• An 82.1% increase in substance abuse office visit claims.
• A 100% upsurge in substance abuse inpatient days claims.

*The percentages listed represent the change in mental health and substance abuse–related claims from 2020 to 2021

Prior to the analysis by the AssuredPartners team, the client had believed a self-guided program might be an appropriate solution for its employees; however, after reviewing the analytical insights, the client agreed it should search for a more comprehensive mental health solution.

Together, our team and the client established a set of four criteria to evaluate all potential programs:

1. Provides fast access to licensed therapists and psychiatrists.
2. Does not require a copay or other fees to be collected from employees.
3. Is available both to employees and their dependents over 18.
4. Is able to serve both domestic and international employees.

The client also desired a program that would encourage more employees to make use of behavioral wellness services when needed. One of our wellness consultants had built relationships with numerous population health management vendors and resources, including many in the mental health space, and led the next part of the project, which included:

• Vetting multiple mental health support programs.
• Presenting seven possible options, outlining the key features and differences of each program
• Setting up vendor demonstrations.
• Actively participating in discussions related to selecting a final provider, developing a program contract, and implementing the program.

In July 2022, the client rolled out an online mental health solution, backed by more than a decade of industry-leading research and clinically proven results, that all employees could access free of charge. Throughout the rollout, we helped  the client communicate and drive awareness to the new program by providing marketing materials describing how the service could help employees and their family members improve their mental health and well-being, as well as when and how employees could sign up for it.

The Findings: Where Does the Client’s Behavioral Health and Wellness Program Stand Today?

Less than a year after program implementation, the client is seeing extraordinary results. Not only has the new service made a significant and positive impact on employees, but it has also led to a measurable reduction in behavioral health claims.

The following are just a few of the promising outcomes to date*:

• 33% fewer mental health and substance abuse–related claims were filed by employees over an eight-month period, leading to an overall benefits plan cost savings of nearly $90,000.
• 58% of people utilizing the program are new to therapy and may not have otherwise sought care if this option was not available to them.
• Employees self-reported they were taking fewer sick days as a result of the program.

*The percentages and dollar amounts listed represent the change in mental health and substance abuse–related claims and costs during the eight-month period from July 1, 2022, to February 22, 2023, as compared to the eight-month period from July 1, 2021, to February 22, 2022.

Even though the client’s new mental health program is off to a successful start, it does not mean our job is over. On the contrary, our team will continue to help promote this program with ongoing communications throughout the year. In addition, we will provide a detailed quarterly report to the client’s leadership and human resources teams that includes updated claims trends and, more importantly, evaluates how employees are engaging in and benefiting from the program.

Employee mental wellness was the highest-priority issue for this client, but your organization may have very different concerns. From stress reduction to diabetes management and financial wellness programs, the AssuredPartners team is poised to assist you in identifying and implementing the population health management solutions that may deliver the most value to both your employees and your organization. Reach out to your local AssuredPartners consultant today to discuss wellness solutions that satisfy the needs of your organization.