America is in a behavioral health crisis. Long before the pandemic, poor reimbursement and budget cuts led to psychiatric hospital closures and a steady contraction in the number of behavioral health beds at acute-care facilities. Now we're facing a historic spike in behavioral health problems and our healthcare system has less capacity than ever to address it.
Consider that more than 42% of people surveyed by the U.S. Census Bureau in December reported symptoms of anxiety or depression, an increase from just 11% the prior year. Additional research has shown pandemic-related spikes in alcohol and drug use, including an increase in opioid overdoses.
In the near term, hospitals caring for high numbers of COVID-19 patients have even less capacity than usual to treat these patients. And emergency department staff are often challenged to find an acceptable transfer because many psychiatric units have reduced bed counts to increase physical distance.
Of course, hospitals will almost surely end up treating these patients eventually—and losing money in the process. That's because behavioral health patients are more likely to suffer poor physical health and require costly medical interventions; they are also more likely to receive Medicaid than hold private insurance. According to a Milliman analysis, annual costs for people who had a behavioral health condition such as anxiety, depression or substance use disorder were about 3.5 times higher than costs for people without those conditions.
Collaboration between providers and insurers is also key when it comes to identifying and managing behavioral health issues before they worsen.
Beyond that, health system leaders are in a unique position to create solutions that expand access to behavioral health services in a way that improves the health of the community and better manages the high costs associated with this patient population.
Across the country, joint ventures between acute-care hospitals and behavioral health providers are gaining traction. Driven by the realization they can no longer meet all of their community's healthcare needs alone, top-tier health systems had already begun forming new, collaborative partnerships even before the pandemic.
With COVID-19 stretching margins thinner than ever before for many, I believe more hospitals and health systems will embrace partnerships to meet growing demand while preserving their ability to invest in core acute-care services.
For example, Oceans Healthcare recently partnered with a large academic health system in the South to create a new behavioral health hospital that more than doubled the number of inpatient beds in the region and created additional space to expand outpatient care and introduce services for a broader population. A similar joint venture between Oceans and a Catholic health system is underway and the model has already been implemented in communities across the country.
These partnerships provide like-minded organizations a way to meet community need in a financially sustainable way. Health systems can retain control and oversight of their behavioral health programs—ensuring quality and consistency with hospital standards—while outsourcing operations to a partner that specializes in the delivery and management of behavioral healthcare. The result is a structure that increases capacity and balances the economics of caring for these patients, offsetting hospital losses and creating a stable program that fulfills its mission.
The pandemic has helped normalize mental health and removed some of the stigma that comes with seeking treatment. Though telehealth has helped more people access care, more inpatient and outpatient treatment options are desperately needed to meet growing demand in communities across the country.
Innovative partnerships between acute-care and specialty providers are the future of behavioral healthcare, and I believe these joint ventures serve as a road map for increasing access to quality care at a critical time for our country.