Quantifying the economic impact of a digital self-care behavioral health platform on Missouri Medicaid expenditures

Abstract

Aim: The primary objective of this study is to estimate the economic benefits relative to return on investment (ROI) of a state-wide initiative to integrate digital behavioral health (BH) self-care into the community BH system.

Methods: The observational study reviewed claims data of 799 people who registered with the digital tool (myStrength) and 715 matched control study participants. The control group was formed via coarsened exact match with blocking variables, including presence on the claims file, volume of health care utilization, participation in a medical health home, BH diagnosis and volume of psychotherapy claims. The primary study analysis of cost differences for the BH self-care tool group versus the control group were calculated by cost setting and the ROI of the BH self-care tool was estimated. Cost settings assessed include inpatient, emergency services, general and psychiatric outpatient, and outpatient psychotherapy.

Results: An incremental annual difference in difference reduction of $382 per user was observed over the 11 month study period in the self-care tool group. Sensitivity analysis indicated an ROI of between 142% and 695%.

Conclusions: Augmenting BH offerings to include digital BH self-care tools appears to generate positive ROI via reduced total cost of care.

Keywords:

• Depression
• digital behavioral health
• claims
• health care cost
• population health
• return on investment

JEL classification codes:

• I10
• I19

Transparency

Declaration of funding

This research was funded by myStrength Inc. and the Missouri Health Foundation.

Declaration of financial/other relationships

SA has disclosed that he is the owner of Propensity4 and was paid as a consultant to provide methods and analysis for the study. A.H. has disclosed that she is a paid consultant for, and owns stock in, myStrength and serves as its Chief Clinical Officer.

Peer reviewers on this manuscript have received an honorarium from JME for their review work, but have no relevant financial or other relationships to disclose.

Acknowledgements

Krista Schladweiler coordinated work and data exchange between partners and helped with writing early drafts of the paper. Alissa Link and Britni Meyers helped collect citations and made finals edits to the paper. Ed Jones and Steven Schwartz both provided high level strategy consultation.