Washington State has developed a new dashboard to track trends in mental health service costs and usage. This initiative, created in collaboration with Onpoint Health Data, aims to provide policymakers and the public with clearer insights into mental health treatment patterns and associated expenses.
The dashboard draws on data from the Washington All Payer Claims Database (WA-APCD) and includes claims data spanning from 2017 to 2022. It encompasses all state-regulated health plans and the Public and School Employee Health Benefit Programs (PEBB/SEBB). By analyzing this data, stakeholders can better understand how residents access mental health services and identify areas that need improvement.
Key findings from the dashboard reveal a notable increase in the proportion of insurance claims related to mental health diagnoses. Between 2017 and 2022, this percentage rose from 11.83% to 17.43%. In urban areas, 18% of enrollees received a mental health diagnosis in 2022, compared to just 13.55% in rural regions. The data also indicates that 7.6% of mental health services were provided by out-of-network providers, a stark contrast to 4.2% for other medical services.
The cost of mental health services has increased significantly over the past five years, with a 69% rise since 2017. This surge is primarily attributed to higher utilization rates of services, despite the average payment to providers per service increasing by only 4%. In terms of monthly costs, per member per month (PMPM) costs rose by 112%, while service usage per 1,000 members climbed by 94%. The average price per service saw a modest increase of 9%.
The dashboard allows users to conduct four types of searches: 1. **Cost Driver** – Users can explore costs by service type, focusing on all enrollees, those with any mental health condition, or those with serious mental health conditions. 2. **Conditions Overview** – This section lets users search for data by year and specific mental health conditions, examining various metrics like outpatient facility rates and emergency department visit rates. 3. **Geographical Overview** – Users can analyze mental health conditions by region, viewing data on pharmacy claims, primary care visits, and inpatient admissions. 4. **Network Analysis** – This feature provides insights into claims by year and region, differentiating between network and out-of-network providers.
For example, if one wishes to understand the cost drivers for psychotherapy, they can select the ‘Cost Drivers’ tab, choose ‘Psychotherapy/Counseling’ from the service type menu, and select ‘All Members’ for a comprehensive look at the data.
The dashboard is a resource for policy experts and legislators, helping them identify patterns in mental health service usage and costs. This data can guide future policy decisions to enhance access and coverage for mental health services across Washington state.
The development of this dashboard was funded by the Centers for Medicare and Medicaid Services (CMS) with a total award of $684,447, aimed at increasing transparency and understanding of mental health services in the state. This project reflects a concerted effort to address the rising demand for mental health care and ensure that it remains accessible and adequately covered by insurance providers.
