A high-risk case management program has shown significant cost savings and better quality of life for workers with comorbid mental and physical illnesses.
Aetna recently released the results from its Med Psych Program, which is geared toward patients with chronic physical and mental illnesses. The evaluation examined claims data for 2,737 HMO members and 1,834 PPO members and tracked medical and pharmacy costs over one year. Data from those enrolled in the program were compared to data from others who have similar health issues but are not enrolled in the program.
The program yielded a cost savings of $136 per member per month, which includes a $175 decrease in medical costs, but an average increase of $11 per month for antidepressants and $39 per month for other pharmacy bills. Employees also reported being at work an average of three additional days per month after joining the program. Furthermore, patients enrolled in the program reported a higher quality of life and improved overall happiness.
The program has been extremely successful in getting patients to the "right place [where] they see the right people and seek the right treatment at the right time," says Dr. Hyong Un, national medical director of Aetna's behavioral health program. "People with chronic medical illnesses really have higher levels of behavioral issues," he says, and this program is helping to "relieve the stigma" of seeking treatment.
The Med Psych Program was developed in 2003 to facilitate the integration of medical and behavioral health services. Case managers provide educational materials, help patients arrange for treatment and formulate a case management plan.
