Aetna: Med Psych Program Members See Lower Medical Costs

August 28, 2007 ( - Those with severe health conditions who were enrolled in Aetna's Med Psych case management program had lower medical costs than those not in the program, according to the health care provider.

In a press release Aetna said those enrolled in the program reported an improvement in their overall quality of life, as well as a decline in work and social limitations.The Med Psych program helps members experiencing mental health issues or who have chronic conditions by integrating and coordinating medical and behavioral health services.
Aetna Behavioral Health recorded a total cost savings of $136 per member per month (PMPM) when members were enrolled in the program compared to members who were not enrolled.
Medical costs decreased by $175, but pharmacy and antidepressant costs rose for members enrolled in the program, specifically, an increase of $39 and $11, respectively.

A post evaluation of enrolled patients showed an increase in self perception of physical and mental health, with enrollees reporting they had been at work three days more per month after enrolling in the program.

“While we saw an increase in pharmacy costs, this was offset by an overall decrease in medical costs,” said Hyong Un, M.D., national medical director for Aetna Behavioral Health, in the press release.

Aetna’s evaluation of claims data included 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 . 

The study looked at claims data for 2,737 Aetna HMO members and 1,834 Aetna PPO members. 

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