Teens Ages 15 to 19 Incur Highest Mental Health Spending for Depression, Anxiety, and Autism Diagnoses, Analysis Reveals

Costs for teens are 31% higher per month than the next closest age group

A new analysis of commercial healthcare spending from Cedar Gate Technologies revealed the highest costs for behavioral and mental health are incurred treating teens aged 15 to 19 years old with depression, anxiety, and autism diagnoses. This age group accounts for at least 31% more per-member per-month (PMPM) spending than any other. Early intervention and effective treatment could save $3,321 per person in healthcare costs within two years. The data comes from Cedar Gate Technologies’ proprietary National Healthcare Benchmark Database, encompassing de-identified data for more than 15 million member lives.

In Cedar Gate’s analysis of 2022 commercial payer data, the top four age groups for PMPM mental health spending are all under age 30:

Across diagnoses, nine of the top 10 highest-cost cohorts were patients under the age of 30 (anxiety treatment for patients ages 30-34 ranked eighth). Behavioral and mental health is also the highest category for healthcare spending overall among children ages 5 to 19.

“Most traditional healthcare spending is incurred to treat older populations, but mental health and behavioral health are unique in that the majority of costs for commercial insurers are going toward treatment for young patients,” said Joseph Siemienczuk, MD, Medical Advisor for Clinical Solutions at Cedar Gate. “Studies confirm that investing in mental health care yields significant savings in future healthcare costs and criminal and juvenile justice costs and improves workplace productivity. It’s critical for everyone to understand these cost dynamics so payers, providers, and employers can make mental health care more available and accessible.”

Of $4.06 billion spent on behavioral and mental health in 2022, commercial insurers in Cedar Gate’s database paid 21% ($845.18 million) toward treatment for children and teens ages 5 to 19. By comparison, total annual medical spending was just 7% for the same group.

Cedar Gate’s value-based care analytics tools include a prebuilt dashboard to help organizations visualize multiple data points related to behavioral and mental health care costs and trends. This data can help improve care for behavioral and mental health patients. It can also help payers, providers, and employers control costs and improve the quality of mental health care available to their members, patients, and employees.

A study by Evernorth Health Services found that behavioral outpatient care following a new mental health diagnosis was associated with a reduction in medical costs of up to $2,565 per person in the subsequent 15 months and $3,321 savings in 27 months.

“Addressing the behavioral and mental health needs of young patients not only improves their overall health and well-being, but studies have also shown that it can dramatically reduce medical costs,” said Cedar Gate Chairman and CEO David B. Snow, Jr. “Cedar Gate’s analytics software is designed to help healthcare organizations uncover critical mental health cost and utilization trends in their population to find the best ways to meet these needs.”

In the U.S., 23% of adults and nearly 17% of youth ages 6 to 17 experience mental health illness, and it is the leading cause of disability worldwide. Millions of people experience the first signs of behavioral and mental health disorders as teens or young adults. Without adequate treatment, these illnesses can negatively impact education, employment, and personal relationships.

May is Mental Health Awareness Month to raise awareness of behavioral health issues. According to the American Psychiatry Association, nearly one in five (19%) U.S. adults experience some form of mental illness.

About Cedar Gate Technologies:

Cedar Gate enables payers, providers, employers, and service administrators to excel at value-based care with a unified technology and services platform delivering analytics, population health, and payment technology on a single data management foundation. From primary care attribution, to bundled payments, to capitation, Cedar Gate is improving clinical, financial, and operational outcomes for every payment model in all lines of business.

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