By | July 10, 2019

Data tells us that people with behavioral health disorders tend to die at younger ages when compared to those without. Evidence is mounting that the highest costs and poorest outcomes are found in those who have comorbid physical and behavioral health conditions, and the costs are not only compounded, but they grow exponentially in some disorders and diseases. Research suggests that the key to better outcomes and controlling costs when treating chronic diseases such as diabetes, obesity, cancer and heart disease, lies in also developing a strong treatment plan for co-occurring behavioral health disorders.

A report released by The National Association of State Mental Health Program Directors  states that persons with serious mental illness die 25 years earlier than the rest of the public. Some of this spike in mortality can be attributed to suicide and injury, however most of it is due to the presence of co-occurring physical disease. For example, 60% of premature deaths for people with schizophrenia are due to medical conditions.

We Must Integrate Care for Chronic Disease Management

This connection between overall health and behavioral health raises questions about how integrated treatment should be approached.

Per research market intelligence published by Open Minds, “The high (and growing) costs of chronic disease—and the very real impact of behavioral health conditions and behavior management—are likely going to reshape care coordination programs and primary care. Payers will be looking for innovative approaches that can demonstrate a return-on-investment in the chronic disease management space.”

A relevant study was conducted by Joseph Sokal and colleagues about medical comorbidity in patients with mental illnesses. They found that individuals with serious mental illnesses (SMI) have higher rates of chronic comorbid conditions than those without them.  In fact, 53% of beneficiaries aged 65 and over with one or more SMI had 3 or more chronic conditions in 2010 compared to 28% of beneficiaries without SMI.

Research shows that people with serious mental illnesses are not only more susceptible to having a chronic condition, but the ones who do can expect total healthcare costs higher than those who don’t.

A psychooncology study found that patients that have cancer and depression have average healthcare costs 113% percent higher than patients not dealing with this comorbidity.  To get more specific, nondepressed patients had average total costs up to $110,650, while depressed patients were paying an average of $235,337.

Other research supports this same scenario for other physical disease, such as the cost of care for heart failure increases by 29% in those where depression is also diagnosed.

 “Comorbidity between medical and mental conditions is the rule rather than the exception.”

mental disorders and medical conditions diagram

Statistically, 68% of adults with mental disorders have medical conditions.  29% of adults with medical conditions have mental disorders.

Research shows the increase in treatment costs are substantial. One study found that in patients with COPD, cancer, diabetes, heart disease and those with comorbidity of mental illness had incurred a 36-97% higher length of hospital stay than those without mental illness.  Identifying and intervening with the patients with SMI and physical comorbidities will be an invaluable part of population health management and health care cost control. Health plans and providers need to harness technology to do just that, and put tools and solutions into place that will enable care coordinators, care managers and providers to focus on those who need focused integrated care to get better outcomes.

Relias Population Health Will Help You Integrate

Our solution will take your data and turn it into actionable information, allowing you to focus on physical and behavioral health interventions for those who might otherwise get fragmented, expensive and reactionary care.

Our tool includes metrics that allow insight and directs best clinical interventions for members of a population diagnosed with physical health disorders such as heart disease, metabolic syndrome and diabetes in tandem with SMI and SUD. The solution also includes pharmacological quality indicators that point to opportunities to improve psychotropic and opioid prescribing patterns tied to best practice.

The Relias population health team, comprised of physicians, pharmacists, psychologists and data scientists and engineers work in tandem to add measures of pertinence. For example, a full suite of measures focused on interventions to prevent readmission and unnecessary emergency room presentations for persons with comorbidities is planned for release in late 2019. Clinical playbooks are included that provide step by step recommendations for behavioral health agencies in implementing disease management programs, such as for comorbid diabetes and SMI consumer populations.

Whole person care requires integration of behavioral and physical health care data to take holistic action, and Relias is committed to being part of the future of health care.

Carissa Kohn-Johnson

Carissa Kohn-Johnson has a background in information technology and is currently the Relias Product Marketing Manager for population health management solutions, focusing on solutions for payers and health plans. She also part of the team that provides performance management, population health management, risk stratification analytics, and practice performance solutions for health plans and behavioral health organizations. She studied Sociology and Gerontology at Nazareth College and Biological Sciences at NC State University.

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