An Advisory Board Analysis: 3 Key Pain Points to Address in Behavioral Healthcare

Prevalence of behavioral health conditions grew 50% in 2021 and continues to steadily increase year over year. To help combat these rising numbers, mental health tech startups were provided funding to grow their service offerings – collectively reaching $5.5 billion globally in 2021.¹

However, many healthcare organizations lack access to data and resources to effectively scope the behavioral health challenges within their local communities – creating a looming care gap for patients in need of comprehensive treatment.

Discover 3 findings from an Advisory Board analysis that can help hospitals better understand and address the growing behavioral health need in their community.

Analysis perimeters

Pulling from the Standard Analytical File (SAF), which contains Medicare fee-for-service (FFS) claims data, Advisory Board wanted to better understand the breakdown of who was presenting to the emergency department (ED) with a depression diagnosis.

Why does this matter?

• Historically, EDs are the care setting of choice for those experiencing mental health conditions. Roughly one in eight visits to the ED is related to mental or substance use disorders.²
• Reported cases of depression have more than tripled since the beginning of the pandemic, placing depression at the top of hospital priorities.³
• These rising cases have hit communities of color more prominently, specifically Hispanic, Latino and Black community members.

Analysis findings

1. Medicare beneficiary claims are just the tip of the iceberg for ED utilization: While over 2 million Medicare beneficiaries with depression were admitted to the ED in 2019, research shows that there are roughly 8 million additional ED visits annually for patients with a depression diagnosis (outside of Medicare FFS).⁴
   
   This not only highlights the need for greater resources for behavioral health but notes the importance of relieving strained EDs as they are often not equipped to treat these conditions.
   
   
2. High risk patients are not equally spread across community demographics: In their analysis, Advisory Board notes, “Black beneficiaries make up 11% of all Medicare claims for beneficiaries presenting to the ED with depression, yet this figure jumps to nearly 17% when looking at the highest risk patients.”
   
   
3. Data limitations are a major cause of the lack of behavioral health advancement: Although depression is a major factor in determining the importance of behavioral health integration there are other conditions that could provide further insight into education and allocation of behavioral health resources. However, most research lacks strong data around other mental illnesses and the races they impact.
   
   As research continues to evolve, hospitals and other organizations will be able to have a better grasp on how to effectively address their community’s unique needs.

One way hospitals can help relieve current ED strains and contribute to ongoing mental health research is through the integration of a behavioral health program. Doing so allows patients to receive prompt and effective treatment without having to travel outside of their community and can help patients experiencing both physical and mental conditions receive comprehensive care under one roof.

Unsure what the next step is for your hospital? Read our white paper, “Effective Hybrid Partnership Models to Enhance Hospital Performance and Outcomes”, to learn why behavioral health integration is so important and how partnership can help.

You may also be interested in: Behavioral Health Integration: Addressing Community Demographics for Improved Patient Outcomes

References:

1. Sullivan, D. (2023, March). 3 findings from our analysis of Behavioral Health Claims Data. 3 findings from our analysis of behavioral health claims data. Retrieved April 3, 2023, from https://www.advisory.com/blog/2022/07/health-equity
2. Weiss, A., Barrett, M., Heslin, K., & Stocks, C. (2016). Trends in Emergency Department Visits Involving Mental and Substance Use Disorders. HEALTHCARE COST AND UTILIZATION PROJECT. http://bit.ly/2BeuB3q
3. The COVID-19 pandemic is finally lifting. but the 'grief pandemic' is just beginning. The Covid-19 pandemic is finally lifting. But the 'grief pandemic' is just beginning. (2023, March). Retrieved April 3, 2023, from https://www.advisory.com/daily-briefing/2021/06/28/grief-pandemic
4. Hill, T., Jiang, Y., Friese, C. R., Darbes, L. A., Blazes, C. K., & Zhang, X. (2020, June 22). Analysis of emergency department visits for all reasons by adults with depression in the United States - BMC emergency medicine. BioMed Central. Retrieved April 3, 2023, from https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-020-00347-6