Employer-Sponsored Behavioral Health Program Impacts on Care Utilization and Cost

OBJECTIVES: To examine the impact of an employer-sponsored behavioral health (BH) program on all-cause health care utilization and cost. STUDY DESIGN: Retrospective analysis of health insurance claims data obtained from a large employer in western New York covering a 25-month period between 2016 and 2018. Those employees treated by the employer-sponsored BH program were compared against a contemporaneous comparison group of employees of the same employer who had eligible BH diagnoses for the program but were treated elsewhere. METHODS: A difference-in-differences method was used to estimate the program's impact on all-cause care utilization (physician office visits and acute care utilization) and total cost of care, including prescription drug costs. RESULTS: Program participation was associated with a reduction of approximately 28% in total cost of care including prescription drug costs (P =.043) over an 18-month period following the initial program encounter, as well as 27% reductions in primary care provider (PCP) visits (P =.001) and non-BH specialist visits (P =.005). No significant impacts were observed for acute care utilization and BH specialist visit rates. CONCLUSIONS: The results suggest that the employer-sponsored BH program implementation may have shifted treatments of certain BH conditions away from PCPs and non-BH specialists who may not have the proper training or resources to manage such conditions. Therefore, these results are consistent with the expectation that improved access to BH care is likely to improve efficiency in the health care system via provision of more appropriate care for those who need it.