Virtual mental health solutions effective, but some boost costs

Virtual care solutions can improve depression and anxiety symptoms; however, some solutions are associated with higher healthcare costs, according to a new report from the Peterson Health Technology Institute [JL1] .

Virtual mental healthcare utilization soared during the pandemic, rising roughly tenfold from 2019 to 2020. Even as other telehealth use in other specialties fell after the peak of the pandemic, telemental health use remained high, accounting for 37% of mental health visits in the third quarter of 2023.

The new analysis focused on solutions in three categories:

• Self-guided solutions: These solutions offer digital content, including lessons and activities, that users can access anytime.
• Prescription digital therapeutics (PDTs): These FDA-cleared, software-based digital therapies offer digitized behavioral interventions; however, they must be prescribed to patients.
• Blended-care solutions: These tools build on the self-guided digital content by integrating virtual care teams with licensed therapists and psychiatrists who deliver mental health treatment.

The researchers analyzed solutions across the categories from 15 companies, including Amwell, DarioHealth, Talkspace, Spring Health, Teladoc Health and Optum.

They found that solutions in all the categories resulted in clinically meaningful improvements in depression and anxiety symptoms. However, the cost impact varied by category. Researchers observed that while self-guided solutions and PDTs can decrease net health spending for commercial payers and Medicare, blended-care solutions could increase health spending as the savings associated with these solutions do not offset their cost.

The report shows that at an estimated $2 per member per month, self-guided solutions reduce net healthcare spending in commercial settings. The solutions reduced spending by $3.6 million per million members. Meanwhile, PDTs are expected to be reimbursed on a per-user basis, at an estimated $280 per episode, generating net savings of $8.7 million per million commercial members.

However, blended-care solutions have a much higher price point -- an estimated $6 per member per month plus approximately $792 in annual therapy costs per engaged user -- that increases total health spending by $25.2 million per million members in the commercial market.

"Virtual solutions for depression and anxiety can expand access to care by offering a range of convenient, affordable, and effective treatment options," said Caroline Pearson, executive director of the Peterson Health Technology Institute, in a news release. "Employers that offer these solutions as part of their benefits package can see lower healthcare spending per user and improved productivity. However, to manage total overall costs, employers must negotiate lower prices for blended-care solutions and help guide users to more affordable treatment options when appropriate."

This is the latest report from  the Peterson Health Technology Institute, which aims to provide independent evaluations of digital care tools. The organization has previously assessed digital hypertension management solutions, virtual musculoskeletal care solutions and digital health tools for type 2 diabetes.

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.