Managing the cost of mental healthcare in the U.S.
Mental healthcare is becoming one of the most expensive challenges of our time — impacting individuals, businesses, and the economy. Rising costs and affordability concerns are straining both individuals and providers.
A recent Columbia Business School study explains how mental illness costs the U.S. $282 billion a year — rivaling the impact of the average economic recession. These challenges are prompting a wave of innovation in how mental healthcare is delivered and supported. With fresh thinking and collaboration, there's an opportunity to create solutions that are more accessible, sustainable, and effective for everyone.
Through Carelon Behavioral Health’s proactive engagement program tactics, we provide scalable, novel approaches that lead to measurable savings. At the same time, we ensure each member receives the help and support they need.
The value of proactive engagement and outreach
Carelon Behavioral Health recognizes the importance of identifying individuals who may be at a higher risk for mental health concerns using advanced predictive models. This pinpoints members with a greater chance of adverse health outcomes and helps them get ahead of their challenges, leading to improved outcomes and lower care costs.
An individual at risk for an adverse event can be identified using historical and real-time data (like medical claims, emergency room visits, or health risk assessments), allowing for proactive outreach. This helps members manage their health needs and mental healthcare issues, leading to reduced inpatient admissions and emergency room visits. We also provide care management support and address social determinants of health — like food insecurity and homelessness — with a range of resources.
Support when it’s needed most
Dedicated teams provide risk reduction planning, community resource connections, and ongoing support. Below are a few examples of how the program can help individuals and leads to positive outcomes.
Social determinants of health
Predictive modeling identifies members at high risk for issues such as homelessness, food insecurity, and abuse. For those with a Health Stress Score of 98 or higher, indicating "toxic" stress levels, immediate interventions by case managers and peer support specialists are initiated.
Program evaluation data from 2024 reports a:
- 14.6% reduction in food insecurity.
- 6.1% decrease in members identifying as victims of abuse.
- 3.2% reduction in homelessness.
- 43 fewer deaths since the program's inception.
Suicide prevention
By identifying individuals at risk of suicidal events on average five months in advance, Carelon Behavioral Health implements safety planning, risk mitigation, and family support services. Aftercare programs are introduced to reduce care gaps.
Data from a 2022 program evaluation report shows a:
- 20% reduction in adolescent and young adult suicidal events.
- 15% decrease in overall self-harm.
- 30% monthly reduction in post-intervention behavioral health spending per engaged member.
Substance use disorder (SUD)
For those at critical risk of adverse outcomes from alcohol or opioid use, we provide phone support, arrange care, and offer coaching to address physical and mental health concerns.
Reviewing program evaluation data from 2024 uncovered a:
- 63.1% reduction in inpatient admissions.
- 39.5% reduction in overdoses.
- 54.6% reduction in emergency department visits.
- 27.5% decrease in inpatient admissions with SUD diagnoses.
Carelon Behavioral Health’s focus on proactive engagement and predictive modeling is just one of the ways we drive cost containment in healthcare. Investing in early intervention and wide-ranging support programs provides health plans with cost-of-care savings. At the same time, health plan members receive enhanced support when needed.
To learn how we can help you reduce spending on mental healthcare while improving outcomes, connect with us for more details.
