Pediatric mental health utilization to cost employers nearly three times as much in 2023, Nomi Health analysis reveals
OREM, Utah–(BUSINESS WIRE)–Nomi Health announced its latest Trends in Spend Tracker, which uses data to call attention and action to key shifts in healthcare costs. The analysis, which is one of the most comprehensive on youth mental health, looking at kids as young as 6 years old in Utah and nationwide, found that adolescent mental health telehealth appointments cost an average $407 per member per year (PMPY) nationally in the last year, up from just $2 in 2019 — an increase of 20,250%, largely due to the pandemic.
Data from the analysis also indicates the youth suicide attempt rate soared 55% in the U.S. from 2019 to 2021. In Utah, 665 lives were lost to suicide and 141,000 adults had thoughts of suicide in the last year. And significantly more children and teens across the country are receiving depression, anxiety and post-traumatic stress disorder diagnoses compared to pre-pandemic levels — up 12% between 2020 and 2021.
Young Utahns are in the throes of a mental health crisis, with the National Alliance on Mental Illness reporting 51,000 Utahns age 12–17 have depression – more than 49% of whom did not receive any care in the last year and are twice as likely to drop out of school. This care crisis is also a cost crisis. The claims analysis from Nomi Health projects a 186% nationwide spike in employer cost next year, at up to $4,000 per affected employee dependent, compared to approximately $1,400 in 2019.
“Once we have data, we have a responsibility to act, no matter how ugly of a reality the data paints. Employers must take into account the impact of this crisis on tomorrow’s workforce and on today’s workplace stability and productivity,” Mark Newman, co-founder and CEO of Nomi Health, said. “Employers looking at this data should ask: Do we have the right benefits in place? Are we prepared to manage costs to take mental health utilization trends into account? Are we providing solutions to help care for our employees and their families?”
Nomi Health’s Trends in Spend Tracker research also found:
- A mental health diagnosis makes a child’s care costs skyrocket. When comparing the last three years of PMPY employer spend on children with and without mental health diagnoses, care for kids who had a mental health diagnosis cost 69% more on average nationwide than for those who did not.
- Youth mental health costs increase sharply with age. Inpatient care costs jump significantly in the U.S. once a youth hits their teens. In 2022, the PMPY inpatient costs were $48 for elementary-age children, $502 for ages 13-15, and $624 for ages 16-19. In Utah, Ogden had by far the highest PMPY inpatient costs at $517 compared to $372 in Provo and $215 in Salt Lake and PMPY professional costs were highest in Provo/Orem at $826 vs. $578 in Salt Lake and $504 in Ogden.
- The gender cost and diagnosis disparity both widened significantly. The cost of youth mental health claims to employers was 27% higher nationally for girls than boys in 2021-22 — up from a 20% gap in 2019. And the mental health diagnosis rate was 44% higher for U.S. girls than boys in the last year, compared to 26% higher in 2019.
- The prescribing rate for medications to treat depression and anxiety has trended upward for years. In Utah, youth with depression were prescribed an antidepressant or another psychotherapeutic drug at a rate of 60% in 2021. Additionally, youth with anxiety were prescribed an antianxiety or another psychotherapeutic drug at a rate of 6% in 2019. The rate jumped to 9% in 2022.
“We have a responsibility to our kids today to commit resources and implement the right strategies to get them the care they desperately need now,” said Dr. Yadira Soler, a pediatric intensivist with Nomi Health. “With healthcare costs spiking and widening the gap between those who do and do not have access, mental health care cannot go unaddressed. The pandemic is no longer front and center, but its impact is very much affecting kids — and employers as a result.”
Nomi Health’s retrospective cohort study analyzed the mental health insurance claims of more than 156,000 patients nationwide ages 6-17 to reveal changes in employer spend, which is indicative of need and demand for care. Conducted by Artemis, a leading benefits analytics platform acquired by Nomi Health in January, the analysis is the latest in the Nomi Health Trends in Spend Tracker series, which investigates costs associated with different health care topics to turn healthcare spend insights into meaningful actions. The last Tracker found long COVID cost employers an average $600 more per member than the average diabetes episode in the first half of 2022.
The nationwide 3-digit number for mental health crisis and suicide prevention services via phone, text and chat is 988. For more information, visit nomihealth.com.
This is a retrospective (Jan. 1, 2019 through July 31, 2022) cohort analysis of the claims of 156,614 insured members ages 6-17 nationally. In analyzing state-level data for Utah, adequate sample sizes were obtained for Salt Lake, Ogden/Clearfield, Provo/Orem. Mental health diagnosis is defined as acute and recurrent depression, anxiety disorders and PTSD, or “reaction to severe stress, and adjustment disorders.” Suicide attempt is defined using the U.S. Centers for Disease Control and Prevention’s defined codes and intent modifiers (used to express intent pertaining to self-harm vs. suicide).
About Nomi Health
Nomi Health is a nationwide direct healthcare system making it easier than ever for any buyer of healthcare to access the highest quality affordable care for their communities. The company’s direct care ecosystem is enabled by technology, and encompasses a real-time operating and payment system — inclusive of analytics and payment rails — as well as an integrated care delivery infrastructure featuring essential care services, pharmacy and an open network. To date, Nomi Health has saved buyers of care an average of 30 percent compared to traditional healthcare costs, while enabling them to give their communities more access to lower cost, high quality care.
From rural counties to some of the largest cities in America, Nomi Health has administered everyday healthcare services to more than 14 million Americans and counting in hundreds of communities nationwide. During COVID-19, this direct care model played a pivotal role in care access, public health and keeping economies open and operating.
Based in Orem, Utah, Nomi Health employs more than 2,000 nationwide, working to lower healthcare expenses, widen care access and improve the patient experience. The company is led by an experienced, cross-functional leadership team with clinical, healthcare, technology and finance backgrounds. Nomi Health has so far invested more than $10 million dollars in improving the well-being of the communities it serves. Visit us on Twitter @NomiHealth and www.nomihealth.com.