Behavioral health costs account for 6% of health plan spending

By Lisa Gillespie

Behavioral health, including depression and stress, is an increasing area of concern to employers, according to the Disability Management Employer Coalition 2012 Behavioral Risk Survey of small, mid-sized and large companies. The concerns and costs — including direct medical expenses, lost productivity, workers’ compensation and disability payments — are made more challenging due to the uncertain future of the Patient Protection and Affordable Care Act.

The survey found that direct costs of mental health care represent around 6% of overall health care costs and nearly 30% of young adults (those aged 18 to 25) were estimated to have had a diagnosable disorder, which is more than any other age group. The estimates for adults between the ages of 26 and 49, and those 50 and over were 22.1% and 14.3%, respectively.

Overall, 11.4 million U.S. adults — about 5% of the adult population — have a disorder that greatly impairs their ability to function in daily life. According to the DMEC survey, 47.7% of respondents believe behavioral risk is an important emerging area of concern. Forty percent include a behavioral component in their integrated or coordinated disability/absence management program.

The survey indicates adoption of behavioral health programs could be impacted by the uncertainty surrounding health care reform. Under PPACA, individual and small group insurance plans will most likely be required to offer parity in behavioral health benefits.

With 78.3% of respondents noting that their behavioral health component is a “carve-in” and is attached to their health plan, they may be reluctant to add/develop programs such as behavioral health if they have to “carve it back out” due to the potential for increasing health insurance costs and the uncertainty associated with the legality of PPACA.

Behavioral health conditions are among the most widespread, damaging and yet preventable illnesses from which people suffer,” says Marcia Carruthers, CEO of DMEC. “It is heartening that awareness of behavioral health and its costs to employees, employers and the entire health care system continues to grow. Employers need legal and regulatory certainty to enable them to effectively manage and reduce these costs.”


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