Cigna Healthcare® has sponsored and provided editorial input on this article.
Identifying people who need behavioral healthcare is becoming easier to accomplish but getting them to the right provider and keeping them engaged long enough to get better is still a challenge.
During an Oct. 22 webinar hosted by Becker’s Healthcare and sponsored by Cigna Healthcare, a panel of Cigna Healthcare and Evernorth® leaders explored how personalized provider matching, predictive analytics, human-centered design and integrated care models can help close persistent gaps in behavioral health access.
Panelists were:
- Stuart L. Lustig, MD, MPH, national medical executive for behavioral health strategy and product design at Cigna Healthcare
- Lisa Kay, MSW, MBA, clinical quality leader at Evernorth Health Services
- Anil Sipahimalani, MD, LFAPA, lead behavioral medical director, enhanced clinical model, at Cigna Healthcare
Here are four key takeaways:
1. Access means more than an available appointment
Dr. Lustig pointed to a striking gap between need and treatment: In 2023, more than 48 million Americans age 12 and older met criteria for a substance use disorder, yet only about 15% received care.1
Workforce shortages, navigation challenges, cost and stigma all play a role and each extra phone call or form is another chance for someone to disengage.
“I think what true access really means is getting the right care from that right person at the right time, and also in a way that someone can truly engage in it and sustain over time,” Dr. Lustig said.
2. The right provider matters
Ms. Kay described Cigna Healthcare’s best match experience, which pairs customers’ preferences with high-performing providers who demonstrate the strongest outcomes for specific conditions. Cigna Healthcare defines therapeutic alliance rigorously, as an individual seeing the same provider three times within 28 days.
When patients reach that alliance with a high-performing provider, Cigna Healthcare has seen appreciable improvement in anxiety and depression symptoms and an additional $50 per member per month in total cost of care savings compared with a standard network match.2
Ms. Kay emphasized that individual choice remains central to the approach. “We know from a therapeutic alliance perspective, you have to feel comfortable with the person you’re interfacing with,” she said.
3. Technology and humans together
Rather than waiting for people to ask for help, Cigna Healthcare combines predictive analytics with clinical rules and real-time data such as admission, discharge and transfer feeds said Ms. Kay.
On balancing artificial intelligence with human connection, Dr. Sipahimalani said technology can flag risk earlier and reduce clinicians’ administrative burden, but it cannot replace empathy or the therapeutic relationship. “Healthcare organizations will succeed when technology augments human judgment, not replaces it,” he said.
That human focus extends to neurodivergent individuals and their families. Ms. Kay shared that Cigna Healthcare conducted more than 20 empathetic interviews with families navigating a new autism diagnosis, which surfaced subtle but important distinctions.
“Readily available information is different than trusted guidance,” she said.
4. Whole-person care
Although behavioral health accounts for roughly 5% of total medical cost, Dr. Sipahimalani noted that people with chronic medical conditions and comorbid mental health or substance use issues have medical costs two to three times higher on average.3
In an integrated model, he explained, a primary care clinician, behavioral health specialist and care manager share one treatment plan, so a patient’s depression and diabetes improve together.
Dr. Lustig applied the same lens to chronic pain, which he said sits at the intersection of psychiatry and the rest of medicine.
“The first thing that leaders need to understand is that saying psychology matters in chronic pain does not mean that the pain isn’t real, because pain is inherently a biopsychosocial experience,” Dr. Lustig said.
Looking ahead, Ms. Kay suggested expanding evidence-based options such as certified peer support, while Dr. Lustig pointed to investing in data connectivity across health systems, providers and patients.
For Dr. Sipahimalani, the most actionable step is meeting patients wherever they first enter the system.
“Embed behavioral health screening, navigation and referral directly into primary care, and any point of entry into the healthcare system,” he said.
1. Substance Abuse and Mental Health Services Administration (SAMHSA), 2023 National Survey on Drug Use and Health (NSDUH): Key Substance Use and Mental Health Indicators in the United States.
2. Based on a 12/25 internal analysis of patients 7/22-6/24 with quality providers, for one full year prior to and following their first diagnosis claim date, who achieved therapeutic alliance. Results may vary.
3. Evernorth Research Institute. Putting Behavioral Health Top of Mind: The Complexities and Importance of Patient Journeys. 2023. Analysis of de-identified medical, behavioral and pharmacy claims data from more than 6 million individuals ages 0–64, 2021–2022.
Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company (Bloomfield, CT), or its affiliates. In Utah, all products and services are provided by Cigna Health and Life Insurance Company (Bloomfield, CT). Some content provided under license.
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