Treating Behavioral Health Woes Might (Or Might Not) Cut Medical Costs

Helping Americans get treatment for mental health problems and substance use disorders may be the right thing to do, but there's no firm guarantee it will cut spending on other types of health care, according to analysts at the U.S. Government Accountability Office (GAO).

The GAO is an arm of Congress that helps lawmakers monitor what's going on in the federal government.

GAO analysts reviewed 29 studies that looked at the effects of behavioral health care treatment on non-behavioral health care costs.

Here's what the GAO analysts found:

20 research teams found that getting behavioral health cut non-behavioral health spending.
6 teams found non-behavioral health spending was lower for people who went without behavioral health care.
3 teams reported mixed results or found that access to behavioral health care had no clear effect on non-behavioral health costs.

"In general, the studies were limited in scope — focusing, for example, on specific behavioral health conditions and their treatment, specific geographic areas, and the costs to specific payers (such as government programs or private insurers) — which precludes comparing study results or summing the various cost estimates," Mary Denigan-Macauley, a GAO acting director, wrote, in an account of the GAO analysts' findings.

How Behavioral Care Could Raise Non-Behavioral Care Costs

Some of the research teams included in the GAO review found that providing care for adults' behavioral health problems might lead to those adults getting care for previously neglected physical health conditions, Denigan-Macauley wrote.

In other cases, she wrote, the cost of the behavioral health care might be too high to produce an equivalent savings on non-behavioral conditions, especially if a patient's only serious health problems are behavioral health problems.

Broad v. Narrow

The research teams with the broadest sets of data were more likely than the teams with narrower sets of data to find that behavioral health care helped cut spending on other types of care.

The only three teams in the review that included the cost of outpatient care, emergency room care, prescription drugs and primary care in their studies did find that access to behavioral health care cut non-behavioral health spending.

Seven of the nine teams that reported mixed or unclear results, or found that access to behavioral health care increased non-behavioral health spending, excluded the cost of prescription drugs from their studies. Eight of those nine teams excluded the cost of primary care from their studies.