Lucet’s recently published report, certified by the Validation Institute, shows the positive impact that our Navigate & Connect solution is having on behavioral health care accessibility.
Key findings: Reducing costs and improving outcomes
The analysis compared 2,944 health plan members who were directly scheduled and kept their appointment with a Lucet-matched clinician to 3,341 members who were screened and triaged, but engaged into care with a non-Lucet matched therapist or psychiatrist (control group). The two groups were evaluated on multiple cost, utilization and demographic variables.
The report revealed that members who were navigated to an appointment with a behavioral health provider through Navigate & Connect experienced substantial reductions in health care costs. There was a $227 per member per month (PMPM) reduction in total medical expenses over a 12-month period, resulting in an impressive $8 million in annual cost avoidance. Hospital admissions were reduced by nearly 19% among Lucet-matched members, while admissions increased by over 6% among those who navigated to care independently.
These findings represent a fundamental shift in how behavioral health care is accessed and utilized. Navigate & Connect provides a structured, tech-enabled solution that actively connects members with clinically appropriate behavioral health providers. Critical to this solution is a clinically informed screener and configurable platform which can map members to the appropriate behavioral health ecosystem resource and provider. Member acuity, preferences and social determinants of health barriers are an important component to evaluating the appropriate resources and driving into the right care. The impact is clear: more effective care pathways lead to better outcomes and reduced health care costs.
“Clinically validated screening, when paired with triage and proper resource matching, can lead to more effective care, better outcomes and increased health plan savings.”
Liz Jones – VP, Clinical Strategy
Implications for health plans
These findings offer a successful blueprint for health plans. By integrating Navigate & Connect into their behavioral health strategies, health plans can improve the quality of care for their members and achieve substantial cost savings. In an environment where health care costs continue to rise, these savings are crucial for maintaining the affordability and sustainability of care — while concurrently improving member experience and reducing confusion regarding behavioral health treatment.
Navigate & Connect’s ability to reduce hospital admissions is particularly noteworthy. Hospitalization is often the most expensive form of care, and reducing these admissions can lead to dramatic cost savings. The solution’s nearly 19% reduction in inpatient stays from the pre- to the post-period, compared to an increase of 6% for those who self-navigated into care, demonstrates its effectiveness. The data show how Navigate & Connect manages members’ health more proactively, gets them connected with providers who can meet their needs, and prevents the need for more intensive — and costly — interventions.
Why this matters for care quality and savings
The key to Lucet’s successful approach is its ability to match members with the right providers at the right time. Our methodology, which included a rigorous comparison between members who Lucet matched into care against those who did not connect to Lucet care, shows a significant cost difference favoring those whom Lucet navigated. Members who saw their matched provider through Navigate & Connect only had an $80 PMPM increase in total medical expenses, compared to a $306 increase in the control group. This difference is a clear sign that clinically validated screening, when paired with triage and proper resource matching, can lead to more effective care, better outcomes and increased health plan savings.
From a quality perspective, ensuring members connect to the right provider is critical to achieving better health outcomes. Behavioral health needs are complex and highly individualized. The Navigate & Connect solution’s ability to tailor connections based on specific member needs results in more effective treatment and better patient experiences. This data-driven approach eliminates guesswork, providing a more streamlined and efficient path to care.
A model for the future of behavioral health
Health plans looking to enhance care quality while managing costs should consider the Navigate & Connect model. Lucet offers a sustainable path forward in a health care landscape increasingly defined by the need for cost-effective, high-quality care solutions.
Read the Validation Institute’s full report and methodology.
Liz Jones is vice president of clinical strategy at Lucet, The Behavioral Health Optimization Company.
