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Timely access to the right provider can make all the difference in behavioral health care, but too often, members face a maze of barriers — appointment delays, confusion and provider mismatches — that lead to costly, ineffective care. A recent analysis of nearly 6,300 health plan members demonstrates how a data-driven approach to care navigation can eliminate these obstacles, improving accessibility and reducing costs.
Health plans need a structured, tech-enabled solution to guide members to clinically appropriate behavioral health providers faster and more effectively. We worked with the Validation Institute to demonstrate the effectiveness of our method (Navigate & Connect)—in increasing access, measuring cost savings and improving outcomes.
The Validation Institute’s analysis compared two groups: 2,944 members who were scheduled with a Lucet-matched provider versus a control group of 3,341 members who were screened but navigated care independently. The results were clear: members who used the Navigate & Connect care-matching platform saw an average reduction of $227 per member per month (PMPM) in total medical expenses over 12 months — an annual savings of $8 million.
Most importantly, hospital admissions declined as well. Inpatient care is among the most expensive health care services, and preventing unnecessary hospital stays translates into improved health care outcomes, better quality of life and major cost reductions. The study revealed a nearly 19% decrease in hospitalizations among Lucet-matched members compared to a 6% increase in the control group, underscoring the program’s effectiveness.
At the core of the Lucet model is a clinically informed screener and a configurable technology platform that matches members with the right behavioral health provider based on acuity, preferences and social determinants of health. Instead of leaving members to find care on their own, Navigate & Connect ensures they land in the right hands from the start.
For health plans, these findings offer a blueprint for improving behavioral health strategies. At a time when health care costs are climbing, Navigate & Connect delivers real savings while simplifying the care journey for members.
This is particularly important in the face of changing demographics. As the U.S. population ages, behavioral health challenges will become even more pressing. By 2040, nearly a quarter of Americans will be over 65, facing greater risks of unaddressed mental health conditions, coexisting chronic illnesses and obstacles to accessing care. With nearly 56% of all health care spending attributed to those over 55 (Agency for Healthcare Research & Quality), ensuring timely behavioral health intervention is critical to lowering avoidable hospital stays.
Navigate & Connect provides an end-to-end solution tailored to whole-person health needs, ensuring those of all ages receive proactive, high-quality behavioral health care before minor issues escalate into costly crises.
For health plans looking to improve behavioral health care while controlling costs, the Navigate & Connect model offers a sustainable solution. It’s a forward-thinking approach in a health care system increasingly focused on cost-effective, high-quality care delivery.
To learn more, read the Validation Institute’s full report and methodology.
Liz Jones is Vice President of Quality and Clinical Strategy at Lucet.
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