research

In the United States, 1 in 4 adults has a behavioral health condition. Of those, two-thirds—or about 25 million people—have a co-occurring medical condition. Adult enrollees covered by Medicaid who have a behavioral health diagnosis incur three times the health care costs compared with people without a behavioral health diagnosis. Much of the increased cost can be attributed to services for physical, not behavioral, health. Individuals with behavioral health disorders are more than twice as likely to describe themselves as having fair or poor health status than those without such conditions. Most importantly, individuals with behavioral health conditions die decades earlier than those without, in part due to preventable medical conditions.

A lack of coordination between physical and behavioral health providers, including limited coordination between mental health and substance abuse treatment providers, contributes to these higher costs and poorer outcomes. For more than one-third of individuals with a mental health disorder accessing care, primary care is their sole source for health care services–their conditions often go untreated or undertreated. At the same time, when an individual receives a majority of their care from mental health professionals, their physical health care needs may go underdiagnosed, undertreated or unmanaged.

In a health care system this fragmented, the opportunities to achieve further integration are vast. To respond to this opportunity, the Association for Community Affiliated Plans (ACAP) convened a collaborative of ACAP-member health plans to focus on improving integration of behavioral and physical health services.

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