Research suggests that patients with behavioral health problems have overall health costs substantially higher than average. Lack of integration of behavioral health services with regular primary care for physical conditions is believed to be a major care coordination issue. Integrating behavioral care supposedly would lower costs and improve quality. An analysis from the Institute for Clinical & Economic Review suggests that rather than saving money, this integration adds substantially to cost. (ICER Article) Focusing on mental health problems, and on use of a “collaborative care model”, the article indicates that overall costs are significantly higher for at least 6 months to two years following adoption of this approach. The report notes that outcomes may often be better under this approach and it offers a list of recommendations for policymakers to encourage integrated approaches.
The reason that costs rise is that behavioral health issues are often untreated and/or may be siloed off from other care the patient is receiving. Integrating behavioral care as a core component of primary care ensures that these issues are managed, which may ultimately lead to better patient engagement in health and better management of physical conditions. Providers who are at risk for all the costs of a particular patient often find it worth the costs to attend to behavioral health problems, as well as the more general social issues these patients face. For these providers, there clearly is a cost benefit. But once again, while we need to control spending, especially by public programs, we also should first be focused on helping patients be in the best possible health. And integrating behavioral and other care likely does that.