The most compelling cost arguments for Integrated Behavioral Health (IBH) do not directly impact the Primary Care practice.  These systemic issues are central to policy makers working on funding and parity, payors working to control costs, purchasers understanding why they should include MH benefits and providers working to improve quality of care.

Reduced utilization
It is estimated that nationally 20% of Primary Care visits are exclusively, and up to 70% partially, for psychosocial reasons.  These psychosocial issues often manifest themselves as medical problems, which until they are detected and treated, needlessly consume medical resources.  Further, resources spent treating depression and anxiety are wasted until underlying problems like substance abuse or PTSD have been detected and handled.  Effective treatment reduces medication usage and many studies have been able to show that IBH reduces the number of Emergency Department visits, a much more expensive activity.

Reduced medical complications
Workplace stress can double a person's risk of dying from heart disease.  Patient's with major depression are four times more likely to have a heart attack and depressed patients recovering from a heart attack are four times more likely to recur.  Patients with behavioral health issues are less likely to handle rehabilitation or adhere to medications, effectively increasing the costs associated with most chronic conditions.

Reduction in associated problems
It is not uncommon for person's with substance abuse problems to have mental health issues, effectively self-medicating.  90% of adults and 60% of adolescences that commit suicide have a mental health condition.  47% of Colorado's homeless have a chronic serious mental illness or chronic substance abuse issue.  In the Colorado penal system, 73% of adults have co-occurring substance abuse issues, while 40% of youth have mental health issues of which 60-80% have substance abuse issues.  IBH is not going to solve all these problems, but it is part of the solution.

Reduced business costs
Psychological problems account for 61% of absences from work each year, 65-86% of employee terminations and 80-90% of industrial accidents.  This tallies up nationally to $116.6 billion in substance abuse costs and $205 billion in untreated mental health costs.  Approximately 90% of adults with a substance abuse or dependence disorder, and 72% of individuals with a mental illness, work.  Treatment success rates are at 80% for depression and 70-90% for panic disorder compared to other medical conditions such as heart disease at 45-50%. 

As an example of how purchasers should be thinking, in a four-year study of program effectiveness, McDonnell Douglas yielded a four-to-one return-on-investment after considering medical claims, absenteeism and turnover.  Not providing mental health benefits impacts the employer's bottom line directly, as well as cost-shifts and magnifies the problem, creating higher premiums for themselves and everyone else.

Please Contact Us to learn more or discuss how Integrated Behavioral Health might work in your setting.