Roughly 1 in 4 Americans have been diagnosed with a behavioral health condition, which can affect their personal and professional lives. In fact, 76% of U.S. workers report at least one symptom of a mental health condition. Yet about 50% of those patients fail to receive adequate treatment, which can have adverse consequences for them and their employers.

Research from Evernorth, the health services division of The Cigna Group, has found that the 22% of patients with a diagnosed behavioral condition drive 41% of total health care spend. Take clinical depression as an example. Clinical depression affects nearly 10% of American adults and the median cost of lost productivity for a single employee with depression is nearly $3,200 a year. In addition, two-thirds of adults with depression do not receive proper treatment, which can make the related workplace productivity costs continue to escalate for employers.

Part of the issue is that finding effective treatment, and navigating the care process, are very challenging for employees. The demand for care today is much higher than the supply of providers, and that demand only continues to grow. The Evernorth study also found that the prevalence of diagnosed behavioral health conditions grew by 4% from 2021 to 2022.

“As a health care system, we need to do a better job of early identification and building personalized care journeys that help match patients with the providers that are best suited to treat their condition,” said Dr. Rodgers Wilson, national medical executive for behavioral health at Evernorth. “We need to come together as an industry to bring more personalized and precise navigation of care to patients. It’s better for both the individuals and the employers sponsoring the plan.”

At Cigna Healthcare, we are committed to connecting individuals with the behavioral health care they need. For example, the Cigna Total Behavioral Health program, which integrates evidence-based behavioral, wellness, and pharmacy services to offer a holistic approach to mental health care, will feature new high-touch navigation features. These enhancements — which include dedicated navigators, in-the-moment clinical consultations, and expanded predictive analytics and outreach — aim to make it easier for working Americans and their families to access personalized and confidential mental health treatment and support. This ultimately benefits both the employee and their employer. “Personalization is the future of health care,” Dr. Wilson explained. “We have to meet the customer where they are with the right treatment, at the right time and at the right place.”

Taking the guesswork out of finding the right care.

Starting in 2024, employees covered under Cigna Total Behavioral Health who call for support will connect with a care navigator, who will provide one-on-one, personalized assistance in identifying appropriate care services. Care navigators will help locate available providers who would best suit the individual’s needs and preferences. They can also explore the member’s benefits package to identify additional services that can help. These navigators will help take the guesswork out of finding the type of care needed and can assist in finding available appointments.  

Clinical real-time support 24/7

For employees with complex or immediate needs, a Clinical Navigator will be designated for that individual and act as a single point of contact throughout the care journey. Clinical Navigators will perform 100% follow-up to ensure all services and providers are effectively addressing the person’s needs every step of the way.

Employees may speak to a Cigna Healthcare clinical professional for immediate expert guidance on developing a care action plan to address their behavioral health issues. Experienced and licensed master’s-level clinicians conduct these “in-the-moment” clinical consultations within the Cigna Total Behavioral Health program around the clock, 365 days a year. Each clinical consultation can last up to 60 minutes, and the number of sessions is unlimited. “If a customer is having a behavioral health crisis, we can assist that customer in the moment at any time,” Dr. Wilson added. “This is revolutionary for health service companies.”

Employees also have access to a personalized digital experience that includes navigation and resources to help create a personalized care action plan. Individuals seeking information and services can visit myCigna to conduct self-assessments and find a list of available providers and support programs that best fit their needs. This digital experience will also enable people to chat virtually with a care navigator if needed. This powerful approach to customer care combines clinical expertise, coordinated support, and intuitive digital tools to empower employees to take charge of their health.

Staying ahead of serious behavioral health needs

In addition to enhanced navigation and consultation, the Cigna Total Behavioral Health program will expand their predictive analytics to identify members in need of care to better inform Cigna Healthcare’s proactive outreach efforts to individuals to confirm and address behavioral health issues in their earliest stages, which helps decrease care costs in the long run.

“By creating more convenient, supportive, and proactive ways to access behavioral health services, Cigna Total Behavioral Health helps employees better maintain their mental well-being, which fosters a healthier, more productive workforce for employers,” Dr. Wilson said. He added that, with appropriate planning and treatment intervention, employers can save up to $2,565 in medical costs per employee over the 15 months after a behavioral health diagnosis.

At Cigna Healthcare, we understand the importance of maintaining, as well as enabling, good mental health in addition to physical health. Cigna Total Behavioral Health is one more way we deliver value to our clients by addressing employee health challenges to improve clinical outcomes, increase workforce productivity and lower total medical costs.

Note: These enhancements are only available for Cigna Total Behavioral Health clients and customers.