Impact of Mental Health on chronic conditions and cost implications- Leveraging data to predict risk

Background: Value-based care systems are increasingly replacing fee-for-service models, as the latter has proven unsustainable. Mental health and their implications on patients are starting to get significant attention in the past decade. Unrecognized mental illness (MI) and their impact on chronic diseases could have a significant impact on disease progression and cumulative cost to the health system. Study design: We have analyzed a large cohort of patients using OptMyCare’s risk stratification system. Predictive analytics using proprietary algorithms were implemented to estimate cost and disease progression in high-risk patients with and without MHD across the cohort. Cost modeling and outputs are resulted as cost per member across chronic conditions with & without MIs. The members with & without MIs were propensity matched for demographics, disease severity and SDOH. Key Results: Members with MI in 8 of the 9 chronic conditions demonstrated a significant increase in cumulative cost. There was a 64% mean increase in claims cost per member with MIs. Conclusion: Utilizing validated algorithms to identify high-risk MI members and implementing disease mitigation strategies targeted at chronic conditions in addition their MI could result in improved clinical outcomes and bend the cost curve.