Behavioral health conditions significantly impact costs of care—with studies linking behavioral health diagnoses with a 3.5x increase in overall care costs and up to a 103% increase in high-cost utilization.
While innovative health plans across the country are working to address these costs through programs tailored to support individuals with behavioral health conditions, patient engagement in these programs remains low. Without proper engagement, care costs for patients increase an additional 8-21%, and both behavioral and physical health outcomes decrease.
CBCS supports health plans across communities in achieving measurable cost savings for behavioral health patients by overcoming barriers to engagement and enlisting community resources to create unified, holistic solutions for improving behavioral health outcomes.
Addressing behavioral barriers to patient engagement
Patients with serious mental illnesses and behavioral health diagnoses, such as substance use disorder (SUD), traditionally have a high treatment dropout rate. In low-income communities this is even more prevalent, with studies showing that 45-60% of adult patients and 80% of adolescents with a behavioral health condition drop out of treatment before the minimal standard for treatment has been met.
The traditional healthcare system requires behavioral health patients to come into a clinic or login to a portal to receive appropriate care, failing to account for the unique socioeconomic and behavioral challenges these patients face. These challenges act as barriers to care, showcasing the need for health systems that both anticipate and address needs such as lack of transportation, means, or motivation in order to ultimately improve program engagement.
CBCS breaks down traditional engagement barriers by meeting patients where they are. 40% of CBCS patients have a mental disorder, 50% have significant substance use disorder, and many face additional social determinants of health which can make it difficult for health plans to reach them through traditional channels, such as phone or mail. As such, CBCS specialist teams instead leverage existing state and private Health Information Exchanges to be ready, 24/7, to meet patients in their moments of crisis and provide both the temporal and clinical support needed to move forward.
By willingly meeting patients where they are—whether at the emergency department, the home, or the McDonalds up the street—CBCS provides a convenient and trustworthy entry point for patients in entering the mental health care system, intervening and triaging moments of crisis to minimize acuity and improve patient outcomes.
Engaging community resources for improved outcomes
When we work within siloed healthcare systems, even the best behavioral health programs fall short by failing to engage with all stakeholders in a patient’s care cohort. Taking conversations outside clinical doors to include the community resources that patients are touching daily is key to holistic and long-term successful care management.
CBCS is a proven facilitator in bringing together community resources to create the care cohorts necessary for total patient care. For members with a behavioral health diagnoses, this could mean bringing together the local fire department, law enforcement, housing authorities, food banks, and shelters to discuss with the patient’s primary care physician, case manager, and therapist what outstanding needs the patient has—and how to troubleshoot a solution as quickly and effectively as possible.
As interdisciplinary teams across the medical and community neighborhood work together to support each other, patients feel cared for and collaboration increases as the unified effort allows all stakeholders to benefit from providing simpler, and more effective care.
Improving cost and clinical outcomes with CBCS
CBCS has proven the cost efficacy of its patient engagement methods—demonstrating an average 5:1 cost reduction rate within the first year of program implementation, and a 10:1 ROI upon subsequent years. And for organizations leveraging CMS or Biden funding grants, that return is even higher.
How? Improving clinical outcomes.
CBCS programs average a 45% reduction to ED visits and hospitalizations and a 41% reduction to no-show rates. In our SUD populations, opioid prescription utilization decreases an average of 30%.
These quick returns support healthy bottom lines for health plans by delivering high-impact results—at minimal upfront cost. All while ensuring high quality and affordability of care, at scale.