Behavioral health has long been an afterthought of the healthcare system. It’s been carved out, reorganized and deprioritized over decades. Now, the U.S. finds itself in the midst of a behavioral health crisis that even massive pandemic-era investments in mental health access couldn’t curb. It’s a crisis that’s particularly acute among young people, and one that doesn’t seem to be going away.
That’s because access on its own isn’t enough to get people the care they need. Health plans have plenty of programs and benefits designed specifically to address the mounting behavioral health crisis. What they have historically lacked is the ability to identify, measure and interpret the data from those programs across populations. Without that, health plans are stuck in neutral in the face of an ongoing crisis that’s costing them and their members dearly.
In 2024 alone, behavioral health conditions drove an estimated $3.5 billion in excess ED utilization. That’s not a sign of a functional system. It’s a signal that upstream interventions are possible if healthcare organizations can find the people who need them.
Bringing a behavioral health lens to existing data
Health plans have all the data necessary to understand which members need help, when and which programs or benefits are best suited to meet member needs. In most cases, they actually don’t need more data; they need ways to extrapolate, arrange and interpret it. They need ways to turn the data they already have, from claims, charts, prescriptions, wearables and other sources, into intelligence that allows them to make informed adjustments to their programs and processes.
Think of it this way: every other aspect of health has been rigorously analyzed, to the point where complications, hospitalizations and costs can be predicted accurately. But when it comes to behavioral health conditions, screening is the primary identification tool and often it only occurs once a year. But mental health isn’t an annual phenomenon. It’s dynamic, fluid, prone to fluctuate based on social and environmental factors.
People share their healthcare information constantly, in ways that go far beyond the PHQ-9. We log our moods and lifestyles with apps, we wear devices that track our health and fitness metrics, we have doctor’s appointments outside of our annual physicals. All of that data, stitched together, presents a full picture – or at least, full enough for health plans to connect the dots.
The opportunity before health plans now isn’t about gathering more data. Rather, it’s about applying a strategic lens to the data they already have.
Making behavioral health insights actionable
Behavioral health intelligence is the missing layer in the analytics stack – one that makes it possible to see past annual screenings, intermittent hospitalizations and one-off therapy appointments to surface the patterns that predict risk, reveal program gaps and show what interventions actually work. NeuroFlow’s BHIQ analytics solution helps health plans and risk-bearing health systems surface behavioral health blind spots by analyzing their existing data and recommending next best actions.
To understand how BHIQ works in practice, consider a health plan with an underperforming diabetes care management program. Despite high enrollment, medication adherence is at 52% and emergency department visits related to diabetes are rising, contributing to millions of dollars in overutilization.
Now imagine this health plan uses sophisticated data modeling, like BHIQ, to identify patterns that point to hidden behavioral health risk. Through BHIQ’s insights, the health plan uncovered that 43% of their diabetic members have untreated or undiagnosed depression. And after running claims data through the model, the health plan found that diabetic members with comorbid depression were 3.2X more likely to skip medications and 2.8X more likely to visit the emergency department.
Here is the most valuable piece of this BHIQ analytics exercise: actionable next steps. Knowing that this high-risk, previously hidden cohort exists, the health plan can target these members with behavioral health screenings to confirm depression symptoms. With a clearer picture of who needs support, the plan can guide the right members to behavioral health programs and benefits that they have invested in, from care management to in-network behavioral health providers to digital CBT. Regular reporting can then reveal the impact of these interventions and lead to continued program design improvement.
The stakes are too high for behavioral health analytics to remain a black box. It’s time for health plans to begin treating behavioral health with the same analytical discipline as physical health. Learn more about NeuroFlow’s BHIQ solution, and how we’re supporting healthcare organizations to drive better outcomes, manage costs and reduce unnecessary utilization.
