• Did you know that globally, as many as 50% of people with chronic pain also suffer from behavioral health (BH)disorders, particularly depression and/ or anxiety?
• Did you know that the cost of medical care has been found to increase by 40% to 80% for chronic pain patients with BH conditions compared to those without them?
• Did you know that depression and anxiety, two of the most common mental health conditions in the world, cost the global economy a whopping $1 trillion each year?

These numbers are alarming (to say the least) because they throw a harsh spotlight on two key observations –

• Patients with behavioral disorders exhibit higher severity of disease
• There’s a higher likelihood of patients with more severe chronic medical conditions to become depressed/ anxious

Against this backdrop, the natural question is “Why do behavioral disorders drive up healthcare costs?” The answer to this “why” is a combination of the following five reasons (from a patient POV):

• Greater worrying and catastrophizing
• Hyper awareness of bodily sensations alongside increased pain perception
• Poor self-care (including a lack of exercise, poor nutrition and diet)
• Lower treatment adherence rates
• Greater tendency to indulge in substance abuse

Physical and Behavioral Health – Cost Connections

Anxiety disorders present themselves as behavioral disturbances, with patients experiencing significant distress and/ or impairment in normal functioning. That anxiety rates have increased by a staggering 25% in the past year alone, therefore, is worrying.

In this context, a Milliman Research Report states that “Studies continue to emerge that suggest patients with depression/ anxiety have a higher burden of medical illness than people without these conditions. Some report 40% or more of high healthcare service utilizers suffer from depression, anxiety, or dysthymia.”

Our topics of interest in this blog are this high utilization of healthcare services, the elevated cost that is associated with it (more money for more caregiving), the extent of increase in this cost that experts observe, and what causes this increase.

From the previously quoted Milliman Research Report, it can be inferred that patients with more severe diseases are often more expensive to treat and that such patients may experience stress-induced social isolation, economic and familial worries that could, in turn, lead to BH disorders including depression/ anxiety. Close monitoring of symptom severity in patients with chronic medical conditions and providing appropriate proactive as well as timely interventions to manage, and treat, resultant BH disorders is, therefore, essential to enable better mental and physical health.

Behavioral Disorders, Cost Escalators, and Causes

In the previous section, I spoke about the ‘more money for more caregiving’ and the ‘up to 80% rise in care costs for chronic patients with BH issues’ aspects.

In this section, I’m going to elaborate on the five reasons/ causes that make care utilization costs increase where BH disorders-afflicted patients are concerned:

1. Greater worrying and catastrophizing – Hypertension is far more common among patients with BH disorders than in those without them, regardless of age or gender. In fact, rates of migraine, gastrointestinal problems, cardiac and respiratory disorders are found to be especially high among those with BH disorders.
2. Hyper awareness of bodily sensations alongside increased pain perception – Compared to people with pain conditions without BH disorders, individuals suffering from pain conditions and BH disorders have increased awareness of symptoms, and feel pain with greater intensity.
3. Poor self-care (including a lack of exercise, poor nutrition and diet) – Patients with BH disorders often fail to/ don’t pay heed to physicians’ directives between clinic visits. This results in the treatment plan performing sub-optimally/ not yielding expected outcomes.
4. Lower treatment adherence rates – A direct fallout of patients with BH disorders not following physicians’ advice is them failing to follow the recommended treatment plan. This results in both patients and physicians not being able to –
   • Gauge how much of the plan is proving to be effective
   • Determine the steps that need to be taken to increase the plan's efficacy
5. Greater tendency to indulge in substance abuse – As stated previously, individuals suffering from pain conditions and BH disorders feel pain differently; often more intensely. The primary aim for such patients during such episodes is near-instant pain relief through alcohol and/ or narcotic drug consumption.

Urban Health to the Rescue

Urban Health is a path-breaking evidence- and measurement-based, AI-guided therapy and care enabling solution that is redefining the delivery of integrative mental healthcare at scale cost effectively. The solution assists provider care teams in treating and/ or reducing the severity of mental illness in patients by –

• Deploying clinically validated assessments to identify, and risk stratify, BH disorders
• Helping care teams make informed treatment decisions through timely triage assessments that –
  ◦ Predict the course of illness
  ◦ Determine the kind, and level, of care a patient requires
  ◦ Carry out suitable interventions
• Implementing measurement-based care to personalize actionable insights-led treatment plans

Urban Health helps users (patients) adhere to their medication regimens and remember their appointments by sending automated timely notifications. It also assists physicians with understanding whether patients are sticking to the recommended treatment, and to what extent.

Cost-related benefits include –

• 17% decrease in annual cost due to effective BH integration
• 53% decrease in emergency/ casualty admissions and visits
• 35% decrease in hospitalizations over a six-month period

To learn more about how you can embrace the integrative care approach, improve patient experiences, contain costs, and enhance financial outcomes, click here.