Return on Investment of Enhanced Behavioral Health Services

Area of Science:

• Health Economics
• Behavioral Health Services Research
• Healthcare Management

Background:

• Employer-sponsored benefit programs aim to improve behavioral health care access and potentially reduce healthcare costs.
• Previous research often focused on clinical outcomes or medical cost reductions without considering behavioral health service costs, leaving the return on investment unclear.

Purpose of the Study:

• To determine if a clinically effective employer-sponsored behavioral health benefit is associated with net medical cost savings.

Main Methods:

• A retrospective cohort study analyzed 13,990 participants eligible for an employer-sponsored behavioral health benefit from November 2019 to May 2023.
• Program users were matched to non-users based on medical risk, diagnoses, and demographics, with a 1-year follow-up before and after benefit launch.
• Net medical spending was assessed using a difference-in-differences analysis, comparing per member per month (PMPM) costs including all medical claims and program expenses.

Main Results:

• The program group showed a net decrease in medical spending of -$164 PMPM compared to the control group.
• This resulted in savings of $1070 per participant in the first year, with a 1.9x return on investment (every $100 invested saved $190 in claims costs).
• Increased behavioral health costs were offset by decreased physical healthcare spending, with greater savings observed in higher-risk individuals.

Conclusions:

• Investing $100 in employer-sponsored behavioral health programs with rapid access to care yields $190 in reduced medical claims costs.
• Expanding access to behavioral health care represents a financially viable strategy for healthcare cost reduction for employers.
• These findings support the integration and expansion of comprehensive behavioral health benefits within employer health plans.