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Aetna Behavioral Health Program Shows Significant Cost Savings and Improvement in Quality of Life and Productivity

Posted on: Thursday, 16 August 2007, 09:18 CDT

Aetna (NYSE:AET) today announced results from an evaluation of claims data for members enrolled in the company's Medical/Psychiatric High Risk Case Management Program (Med Psych). Med Psych is a specialty program that targets members who have co-occurring medical and behavioral health conditions such as diabetes and depression. The results show that members who were enrolled in the Med Psych case management program had lower medical costs compared to members with a severe health condition, who were not managed in this program. Enrolled members also had a self-reported improvement in quality of life as well as a reduction in work and social limitations.

"These results are encouraging because we now have hard evidence that integrating the case management of behavioral health care and pharmacy with medical can have a positive impact on members' overall health and help to manage the costs associated with chronic conditions," said Hyong Un, M.D., national medical director for Aetna Behavioral Health. "In addition to examining claims data, Aetna continuously solicits feedback to measure members' perceptions about their health. Our surveys have shown a significant increase in self perception of physical and mental health and an increase in productivity as a result of the Med Psych program."

The evaluation of the program looked at medical, pharmacy and utilization costs over a one year period and compared members who were enrolled in the Med Psych program with those who were not enrolled. The study looked at claims data for 2,737 Aetna HMO members and 1,834 Aetna PPO members. A post evaluation of enrolled patients showed an increase in self perception of physical and mental health as measured by SF12 scores.

The SF12 is an industry standard, 12-item, self-administered questionnaire that assesses symptoms, functioning and quality of life. Enrollees also reported they had been at work three days more per month after enrolling in the program.

Aetna Behavioral Health demonstrated a total cost savings of $136.00 per member per month (PMPM) when members were enrolled in the program compared to members who were not enrolled. In addition, the results show that medical costs decreased by $175.00 PMPM, but pharmacy and antidepressant costs rose for members enrolled in the program, specifically, an increase of $39.00 PMPM and $11.00 PMPM respectively.

"While we saw an increase in pharmacy costs, this was offset by an overall decrease in medical costs," said Dr. Un. "We believe these results are evidence that the program had a positive impact on adherence to medication for both behavioral health and co-morbid chronic medical conditions," Dr. Un added.

The Med Psych program was developed in 2003 to help members experiencing depression or other mental health issues who also have chronic conditions such as cancer, diabetes or congestive heart failure. The purpose of the program is to provide integration and coordination of medical and behavioral health services. Med Psych case managers help members arrange for treatment with health care professionals, provide educational materials and work with treating providers in the development of a medical psychiatric case management plan.

Aetna is one of the nation's leading diversified health care benefits companies, serving approximately 34.9 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life, long-term care and disability plans, and medical management capabilities. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans and government-sponsored plans. www.aetna.com

Source: Business Wire

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