Impact of Coexisting Mental Illnesses and Chronic Conditions on Healthcare Utilization and Cost at Blue Cross and Blue Shield of Louisiana

Speaker(s)

Kaur G, Liu M, Evans T, Ouyang J, Bergeron T, Vicidomina B
Blue Cross Blue Shield of Louisiana, Baton Rouge, LA, USA

Presentation Documents

OBJECTIVES: Around 40 percent of adult members enrolled in Blue Cross and Blue Shield of Louisiana (BCBSLA) have a mental illness along with chronic conditions. This study investigates whether the coexistence of mental illness with chronic conditions increases the non-mental health (non-MH) utilization and cost compared to members with only chronic conditions.

METHODS: This study considered BCBSLA members who encountered chronic conditions during 2022 and were between 18 and 64 years old. Healthcare utilization and cost were investigated between the members with chronic conditions only and the members with mental illnesses along with chronic conditions. Researchers used generalized linear models (GLM) to quantify the impact of mental health illnesses with chronic conditions on healthcare utilization and cost while controlling factors such as gender, region, age, plan type, chronic comorbidities, race, and socioeconomic factors. A GLM with log link and Gamma distribution was used to find the relationship between cost-related measures and cohorts (with/without mental illnesses). Utilization measures were generalized with Poisson/Zero-inflated Poisson distribution. Finally, researchers computed the rate ratio to examine the difference in utilization and cost between the two cohorts.

RESULTS: The results indicate that the members with both chronic conditions and mental illnesses have 108 percent higher non-MH acute inpatient admission cost and 67 percent higher non-MH ambulatory emergency department (ED) visit cost, which is associated with 98 percent higher non-MH acute inpatient admissions and 55 percent higher non-MH ambulatory ED visits. Overall, the members with both conditions have 52 percent higher all-cause medical cost when compared to members with chronic conditions only.

CONCLUSIONS: The coexistence of mental health illnesses worsens chronic conditions and health status, which leads to an increase in non-MH-related cost and utilization of acute inpatient admissions, ED, primary care, urgent care, and specialty visits.

Code

CO57

Topic

Clinical Outcomes, Economic Evaluation

Topic Subcategory

Clinical Outcomes Assessment, Comparative Effectiveness or Efficacy, Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Mental Health (including addition), No Additional Disease & Conditions/Specialized Treatment Areas