Design and deploy a robust array of purpose-built behavioral health management programs and partnerships across the mental health spectrum from stress resiliency through serious mental illness needs
Behavioral health is top of mind for stakeholders across the healthcare ecosystem. The industry has recognized the criticality of diagnosing and treating mental health conditions appropriately—and, the consequences of not doing so.
For patients, seeking routine medical care can already be a disjointed and overwhelming experience, and underlying behavioral health problems can dramatically exacerbate illness and care cost.
Innovative, new models focused on integrating behavioral health treatment into care models are driving meaningful outcomes for patients. However, additional work is required to develop and change the corresponding business models and industry structures to support and accelerate adoption of these new care models and address the accessibility and equity challenges that remain.
Common issues we help our clients solve
How can we address the behavioral health needs of our members in a cost effective way?
What are the care models we can deploy to address the behavioral health needs of our population and drive changes in utilization patterns and outcomes? What role does new technology, new delivery models, and new integration play?
How can we better match supply with demand in the behavioral health space?
What are the reimbursement models to consider to ensure delivery of affordable behavioral health care?
What behavioral health capabilities should we in-source vs. vend?
American adults live with a mental illness
Spend on BH at 5% CAGR; driven by increasing demand, unmet needs and regulatory shifts
Impact on key utilization metrics such as IP admits and ER visits for patients with BH conditions
Clinician shortage driven by tough reimbursement and regulatory environment. Has resulted in a significant portion of clinicians not accepting insurance and charging high cash pay only rates, creating behavioral health access inequity
Of individuals with a BH condition do not receive BH treatment
Of individuals reported BH symptoms in ‘21 versus 11% in 2019. Isolation and stress fueled by the pandemic is creating a toll on mental health
Source: Oliver Wyman analysis
Patients with behavioral health needs can enter the system at one of several touchpoints. Depending on their response to treatment, they can, and usually do, continually move forward and back across the spectrum. Often their access to care is limited and the care they do receive is fragmented.
Source: NAMI, OWID, ADAA, Harvard Medical School, Office Journal of American Academy of Pediatrics, Johns Hopkins
Source: NAMI, OWID, ADAA, Harvard Medical School, Office Journal of American Academy of Pediatrics, Johns Hopkins
Behavioral Health issues have entered a new phase of public discourse, especially following the pandemic. Efforts to destigmatize behavioral health challenges is positive, an increase in demand for services is putting pressure on an already strained system. Roughly 37% of Americans in 2021 lived in an area suffering from a shortage of mental health professionals. As a result we see several trends that are shaping the state of the evolving behavioral health landscape
Telemedicine Increases
Digital Health Investment Explosion
Coverage Expansion
Focus on Behavioral Health Integration
Growing Health Equity Gap
Continue to destigmatize Behavioral Health: There’s been progress in making mental health more of a mainstream conversation, but more needs to be done to ensure that we are giving mental illness the same level of attention and care as physical ailments. The public discourse that has emerged recently must continue and government leaders need to keep BH a top priority to improve for all Americans.
Improve access and fix the supply/demand model: A continued expansion of BH benefits covered by insurers and self-funded is an important aspect of closing the access gap-for both adults AND youth. The popularity of BH digital tools presents an opportunity for providers to ease the supply-and-demand equation and explore additional lower-cost touchpoints. In addition to digital therapies, we need to find ways to optimize the limited supply of behavioral health specialists that are in the ecosystem today. Our navigation and referral programs need to ensure that psychiatrists and psychologists are available to those with higher acuity needs, while deploying other mental health professions and approaches such as peer support programs and specialists, pastoral counselors, art and music therapists, and nurse psychotherapists for lower acuity cohorts where appropriate.
Deploy a new more responsive and integrated care model: While the proliferation of solutions and organizations focused on delivering BH services is positive momentum, often BH care is fully separated and fragmented. There are examples across the nation of more fully integrating BH care into medical care that have shown signs of success, but we are in the nascent days of those models. We need to move beyond the days of BH care primarily being delivered as 30 second depression screening questionnaires to a more robust and connected whole person mental and physical health care.
Oliver Wyman has successfully partnered with our clients to create tailored BH strategies and integrate BH into broader Medical and Pharmacy initiatives.
Enabled client to bring best of both organizations to member care by supporting care model integration of a newly acquired Medicaid plan, with a detailed evaluation of the behavioral health program and transition roadmap to bring behavioral health in-house. Read more
Performed analysis of the behavioral health patient journey to uncover $5M revenue lift through improvement in kept appointment rate, patient retention, and revenue cycle management. Read more
Redesigned the population health management model of a Medicaid plan, including assessing the care model and approach for managing members with behavioral health conditions, identifying members with highest opportunity and need for additional behavioral health services, and defining the roles for BH specialists and social workers across an integrated care team. Read more
Assessed the mental health innovator landscape to support the client’s digital therapeutics and digital phenotyping strategies. Read more
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