The Business Case for Preventive Behavioral Health: Moving from Crisis Management to Proactive Care

The behavioral health crisis is no longer just a clinical challenge, it's a strategic business imperative. With mental health claims increasing by over 30% in recent years and untreated behavioral health conditions driving up to $290 billion in avoidable costs, health plans must shift from reactive crisis management to proactive prevention. 

In a recent webinar, NovaOne's clinical leaders Rachel Goldberg, Vice President of Client and Provider Success, and Janice Rybicki, Director of Client and Provider Success, made a compelling case for why health plans must shift from reactive crisis management to proactive prevention strategies. 

Why Integration Matters 
"Your brain is an organ just like any other body part, and it should be treated with the same rigor, both scientific and clinical, as any other organ in the body," explains Rachel Goldberg, Vice President of Client and Provider Success at NovaOne. 

 The data is compelling: individuals with behavioral health needs are twice as likely to have chronic diseases like diabetes or heart disease. Yet while physical health has clear prevention protocols -annual checkups, screenings, blood work - mental health lacks the same structured approach. 

Four Strategic Advantages of Prevention 

1. Preventing Escalation: Evidence-based treatment for specific conditions helps members improve clinically while avoiding costly ED visits and inpatient admissions. 
2. Strengthening Engagement: Offering choice in how members access care - from self-guided tools to coaching to clinical treatment - drives satisfaction and long-term trust.
3. Enabling Value-Based Care: Prevention reduces high-cost interventions and keeps members in sustained, effective outpatient care.
4. Supporting Workforce Sustainability: Proactive stress and burnout management creates wins for productivity and retention. 

The Engagement Gap 
When health plan leaders were polled during a recent webinar, the majority indicated they have preventive tools available, but face significant engagement and awareness challenges. The solution? A coordinated approach that reduces stigma, clearly communicates value, and guides members to the right resources at the right time. 

Building a "Front Door" to Care
NovaOne's approach centers on creating a single entry point that simplifies access through:

• Clinically validated screenings (PHQ-9, GAD-7)
• Actionable insights that explain results and next steps
• Navigation to appropriate case based on severity
• Progress tracking over time

This front door provides real-time data on what members are experiencing - a significant advantage over delayed claims data that allows plans to respond proactively. 

Three Essential Prevention Tools 

• Microlearnings: Short evidence-based content members can access on demand - like a three-minute breathing exercise.
• Sleep Training: CBT-I techniques that impact both behavioral and physical health conditions.
• Skill Building: Practical coping strategies using CBT and DBT approaches that reduce symptom recurrence.

Real-World Impact 
Consider Martin, a 58-year-old diagnosed with stage 2 colon cancer. Through proactive screening by his nurse case manager, his depression and anxiety were identified early. He was quickly connected to virtual coaching and therapy, learned distress tolerance and mindfulness skills, and successfully completed treatment with significantly reduced symptoms. 

 The key insight? Implementing prevention requires cultural change. As Goldberg emphasized, "A culture of integration, a culture of stigma reduction is key in order to become a culture of prevention."

 Five Steps to Implement Prevention at Scale 

1. Assess Your Current State: Understand your population risks, gaps and existing resources.
2. Integrate Digital Screenings: Enable regular mental health check-ins.
3. Build Prevention Pathways: Route members to the right interventions.
4. Coordinate Care System-Wide: Align primary care, case managers and specialists.
5. Monitor and Iterate: Track KPIs and continuously improve.

"You can't just put something in place and sit back," notes Janice Rybicki, Director of Client and Provider Success. "We have to reiterate time and time again." 

Addressing Common Concerns 
"Why invest in prevention when members may leave in 36 months?" 
Goldberg's response: "Because it's the right thing to do." But Rybicki adds strategic perspective: "What if all health plans were doing prevention? Then you're getting members who already have this experience. It's our collective responsibility."  

Focus on clinical foundation, proven implementation success, and robust monitoring of member outcomes. Also consider rapid access - even the best treatment model fails if appointments take two months. 

"Solely increasing access by increasing sheer volume of practitioners is not going to enable the outcomes that we all want," Goldberg emphasizes. "It really has to be the right type of clinical support for each clinical need." 

The ROI Extends Beyond Cost Reduction
While reducing ED visits and inpatient admissions matter, prevention also delivers:

• Improved member engagement and satisfaction
• Increased trust in the health plan
• Better clinical outcomes across the population
• Long-term cost curve bending

Ready to Learn More? 
This article only scratches the surface of what's possible with preventive behavioral health. To dive deeper into implementation strategies, get the full webinar recording here.