Understanding behavioral health
Mental health is just as important as physical health. Learn more about the importance of behavioral health, today’s behavioral health landscape and how Evernorth is working to improve health outcomes and costs of care.
Defining behavioral health
Mental health. Resilience. Well-being. All of these terms describe what health care professionals refer to as “behavioral health."1 These needs exist on a spectrum of severity and complexity—from higher-acuity conditions like autism and schizophrenia, to lower-acuity conditions like stress and anxiety.
Failing to address unmet needs can have dire consequences—not just on health outcomes, but also on total health care costs.
The need for care is rising, along with spend
Demand for behavioral health services has increased substantially in recent years. This trend emphasizes the importance of ensuring access to care at an affordable price.
29%
increase in prevalence for behavioral health conditions from 2018–20234
110%
increase in behavioral health spend4
The state of behavioral health care—and why it needs to change
The current health care system presents many complex challenges that can prevent individuals from accessing critical behavioral care when and where they need it.
Gaps in care can arise from many factors, including:
Lack of affordability or access
Stigma associated with seeking mental health support
Disconnected medical, pharmacy and behavioral health services
Social determinants of health (SDOH), such as socioeconomic status, housing or food security
Patients are experiencing delays in care
Whatever the reason may be, the downstream impacts of delays are significant as health problems can escalate into more serious and costly conditions over time.
90%
of adults with a behavioral condition also suffer from Physical health conditions- with costs up to 6X higher5
~55%
of adults with a mental health condition never receive treatment.6
~88%
of patients get their behavioral medications from non-behavioral providers where a connection to therapy may not exist.7
Behavioral health by the numbers
Our vast, integrated data from across the health care system shows where gaps in care are most prevalent, helping us to identify who needs help the most.
Two in five youths with a mental health diagnosis did not receive treatment within six months of their initial diagnosis.8
48%
of parents said their child was being treated with medication only8
28%
increase in young people with mental health diagnosis8
48%
increase in those with at least two mental health diagnoses8
Tackling youth mental health is imperative
Eva Borden, President of Behavioral Health,
Evernorth Health Services
~10% of members living in areas of higher social need are less likely to receive treatment
We can harness this data—as scored by the Evernorth Social Determinants Index (ESDI)—to identify and engage members who are experiencing gaps in care and guide them to the right resources for their needs.
Percentage of members who receive treatment9
View percentage of members who receive treatment chart as table
View percentage of members who receive treatment chart as table
| Demographic | Percentage of members |
|---|---|
| Male | 76% |
| Female | 84% |
| Asian | 73% |
| Hispanic | 74% |
| Black | 76% |
| White | 83% |
| Higher social need | 76% |
| Lower social need | 84% |
Advancing health equity
Evernorth is committed to identifying disparities in health and driving greater access to behavioral health treatment.
Always-on behavioral health services
Achieving different outcomes requires a different approach. Evernorth’s unique capabilities and solutions ensure members receive faster, easier access to behavioral care—24/7/365.
Proactive engagement
Our deep, integrated data across medical, pharmacy and behavioral health allows us to identify and engage untreated members sooner.
Easy access
First-time appointments available within 3 business days.
On-demand human connection
In-the-moment care from a licensed clinician is available via phone, text or video.
Broadest behavioral care
Our network of +392K providers supports the full spectrum of behavioral health challenges—from stress to schizophrenia, to substance use and more.10
Closing the behavioral health gap
At Evernorth® Health Services, we take a data-informed approach to care and provide personalized support across the entire behavioral health continuum for the populations we serve.
A comprehensive, cost-saving approach to behavioral care
Our solutions help members achieve better mental health and emotional well-being by leveraging sophisticated identification models to proactively engage, swiftly navigate to the right level of care and deliver quality health outcomes that drive cost savings for both members and plans.
Sources
Substance Abuse and Mental Health Services Administration (SAMHSA). “Behavioral Health Integration.” American Medical Association (AMA), 2022.
“What is behavioral health?” American Medical Association (AMA), 2022.
National Alliance on Mental Illness (NAMI). “Mental Health Conditions”
Cigna 2018- 2023 Commercial and IFP BOB data, with medical, behavioral and pharmacy continuous coverage over the year. The prevalence of antidepressants has increased among all ages and genders. Females continue to have a higher use. Cigna 2018- 2023 Commercial and IFP BOB data, with medical, behavioral and pharmacy continuous coverage over the year. For individuals with behavioral conditions, 65-75% of total spend is driven by medical spend.
Evernorth Behavioral Health Insights, Book of Business claims data 1-1-20 through 12-31-20. Adults only. Results may vary.
Mental Health America (MHA). “Access to Care Data 2023.” [Data set].ESI BOB insights, 2023.
For a healthy workforce, curbing the youth mental health crisis is imperative (Evernorth Research Institute, 2024).
Claims were based on a 12-month period from January 1, 2023 through December 31, 2023 for customers with continuous medical, behavioral and pharmacy eligibility. Behavioral diagnoses were defined as any International Classification of Diseases 10th Revision (ICD-10) code starting with Fxx.xx within the first 5 diagnosis code fields on a medical or behavioral claim, excluding nicotine only and including suicide and self-harm.
Unique provider data as of April 2024.