Meeting The Challenges Of Mental Health Care

A recent Columbia Business School study explains how mental illness costs the U.S. $282 billion a year — rivaling the impact of the average economic recession. These challenges are prompting a wave of innovation in how mental health care is delivered and supported. Employers can help with this effort by offering workplace benefits that support mental health and drive awareness to maximize their impact. They can also help by promoting work-life balance. With fresh thinking and collaboration, there's an opportunity to create solutions that are more accessible, sustainable, and effective for everyone.

Trusted partners like Carelon Behavioral Health, which provides behavioral health services for Anthem Blue Cross and Blue Shield members, have proactive engagement program tactics with scalable, novel approaches that lead to measurable savings for employers and employees.¹ These efforts ensure each member receives the help and support they need. Let’s walk through Carelon Behavioral Health’s approach.

The Value Of Proactive Engagement And Outreach

Proactive engagement starts with identifying individuals who may be at a higher risk for mental health concerns using advanced predictive models.² This means pinpointing members with a greater chance of adverse health outcomes and helping them get ahead of their challenges, leading to enhanced employee well-being, lower costs, and higher productivity.

An individual at risk for an adverse event can be identified using historical and real-time data (like medical claims, emergency room visits, or health risk assessments), allowing for proactive outreach. This helps Anthem members manage their health needs and mental health care issues, leading to reduced inpatient admissions and emergency room visits. This type of care management support helps address social drivers of health — like food insecurity and homelessness — with a range of resources, ultimately lowering the cost of care for employers and employees.

Support When It’s Needed Most

Dedicated teams provide risk reduction planning, community resource connections, and ongoing support. This can lead to a healthier workforce and reduced healthcare spending. Here are a few examples of how the program can help individuals improve mental health and lead to positive outcomes:

• Social Determinants Of Health

   

  Predictive modeling identifies members at high risk for issues such as homelessness, food insecurity, and abuse. Case managers and peer support specialists initiate immediate interventions for members with a Health Stress Score of 98 or higher, indicating "toxic" stress levels.

   

  According to Carelon data from 2024, these interventions have led to the following improvements:

   

  • 14.6% reduction in food insecurity
  • 6.1% decrease in members identifying as victims of abuse
  • 3.2% reduction in homelessness
  • 43 fewer deaths since the program's inception

• Suicide Prevention

   

  Carelon identifies members at risk of suicidal events on average five months in advance. This effort is part of implementing safety planning, risk mitigation, and family support services. Aftercare programs are introduced to reduce care gaps and have made a demonstrable impact.

   

  Data from a 2022 Carelon program evaluation report shows these improvements:

   

  • 20% reduction in adolescent and young adult suicidal events
  • 15% decrease in overall self-harm
  • 30% monthly reduction in post-intervention behavioral health spending per engaged member

• Substance Use Disorder (SUD)

   

  For those at critical risk of adverse outcomes from alcohol or opioid use, Carelon provides phone support, arranges care, and offers coaching to address physical and mental health concerns.

   

  Carelon’s program evaluation data from 2024 shows significant cost reductions due to more effective interventions:

   

  • 63.1% reduction in inpatient admissions
  • 39.5% reduction in overdoses
  • 54.6% reduction in emergency department visits
  • 27.5% decrease in inpatient admissions with SUD diagnoses

Focusing on proactive engagement and predictive modeling is an important way to drive cost containment in mental health care. By investing in early intervention and wide-ranging support programs, employers can control cost of care, improve employee well-being, and enhance employee productivity to meet their business goals.  

1 Carelon Behavioral Health is a separate company providing behavioral health services on behalf of Anthem Blue Cross and Blue Shield.

2 The predictive models are included in the Carelon services offered as part of the Anthem Behavioral Health Premium Product.