Focusing on Behavioral Health Can Improve Medicaid Patient Population Health
A recent presentation at the World Congress 10th Annual Medicaid Managed Care Summit outlined how behavioral health analytics can be employed to improved the overall health of an insurer’s Medicaid member population.
Michael Golinkoff, PhD, president and CEO of PerformCare, and Candace Saldarini, MD, medical director at ODH INC, presented their research, entitled “Utilize Behavioral Health Analytics to Improve Your Medicaid Population Health Management Strategy.”
Drs Golinkoff and Saldarini highlighted that while behavior health only accounts for 4% of overall spending, capturing and treating issues with behavioral health can save significant health care costs because 68% of adults with behavioral conditions also have other medical conditions. They noted that 5% of the patient population with complex conditions make up more than 50% of overall spending, stressing that behavioral health strategies which impact this portion of the population can have significant impact.
They cited research from the Center for Health Care Strategies showing that costs among members with behavioral health comorbidities in addition to chronic health conditions represent significantly more costs than patients with only chronic conditions. For example a patient with diabetes accounts for an average annual cost of about $9498, while a patient with diabetes and a behavioral health condition can make up $36,730.
Drs Golinkoff and Saldarini described a platform that was developed to address this issue, known as Mentrics. The platform can comb through massive amounts of patient data to predict the need for out-of-hours services and readmissions. Health plans can then use this information to develop precision services in order to reduce the likelihood of overutilization.
The platform automates workflow in order to retain institutional/clinical knowledge, identifies high-risk members in real time, and provides a detailed user interface to monitor member activity—such as prescription utilization.
According to the presentation, through use of analytics, payers can target members with behavioral health conditions to individualize treatment and produce quantifiable outcomes. —David Costil
