High-Need, High-Cost Patients: The Role of Behavioral Health

October 30, 2015

Behavioral health conditions, including mental health issues and substance use disorders, affect nearly one in five Americans and account for $57 billion in health care costs annually. This briefing discussed current initiatives to integrate behavioral and physical health care services in order to improve quality of care and reduce overall health care costs.

If you were unable to attend the briefing, here are some key takeaways:
Jose Figueroa, researcher, Harvard University T.H. Chan School of Public Health
FEW INTERVENTIONS SUCCEED. Since high-cost, high-need Medicare beneficiaries have the highest incidence of behavioral health issues, segmenting them into categories allows for better understanding of spending and utilization patterns across similar groups, thus creating the potential for more successful interventions, Jose Figueroa stated.

Howard Goldman, professor, University of Maryland
COLLABORATION CUTS COSTS. The Collaborative Care intervention, implemented in 18 primary care sites and eight states, integrated behavioral health practitioners into primary care settings, Howard Goldman explained. Results found that Collaborative Care doubled the effectiveness of treatment for late life depression and saw cost savings of over $3,000 for an investment of about $500, he continued.

Jeff Richardson, executive director, Mosaic Community Services
ADDRESSING SOCIAL DETERMINANTS OF HEALTH KEY. Without addressing the social determinants of behavioral health, interventions will fail, Jeff Richardson stated. He cited examples from Mosaic Health’s program in Baltimore city, where they provide addiction, mental health, pain management and primary care services in a coordinated setting and have implemented collaborative care models with Federally Qualified Health Centers and pediatric practices.

Benjamin Miller, director, Eugene S. Farley, Jr. Health Policy Center, Department of Family Medicine, University of Colorado School of Medicine
INTEGRATION REDUCED MEDICAID SPENDING. We need to change the culture of addressing behavioral health and substance abuse issues and dispel the one-size-fits-all myth, Benjamin Miller stated. A program in Colorado, Sustaining Healthcare Across Integrated Primary Care Efforts, made behavioral health providers part of the primary care team and gave them a budget to use at their discretion, moving away from fee-for-service. In 18 months, there was a 5.5 percent reduction in Medicaid spending across the three practices studied, he shared.

Ed Howard of the Alliance for Health Reform and Melinda Abrams of The Commonwealth Fund co-moderated the panel discussion.

Follow the Briefing on Twitter: #BehavioralHealth

Contact: Monica Laufer mlaufer@allhealth.org 202-789-2300

The event was co-hosted by the nonpartisan Alliance for Health Reform and The Commonwealth Fund.


Full Transcript (Adobe Acrobat PDF)

Speaker Presentations

Benjamin Miller Presentation (Adobe Acrobat PDF)
Jose Figueroa Presentation (Adobe Acrobat PDF)
Melinda Abrams Presentation (Adobe Acrobat PDF)

Event Details

Agenda (Adobe Acrobat PDF)
Speaker Biographies (Adobe Acrobat PDF)