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How Livongo accounts for behavioral health challenges in chronic condition management

Dr. Julia Hoffman

11.01.19

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In the midst of dramatic progress and innovation in healthcare, the understanding and treatment of chronic conditions such as diabetes continues to evolve. But there’s something even more important developing: an expanded awareness of the impact that behavioral health conditions can have on a person’s overall health—and how it is impacting costs.

Unfortunately, the combined impact of chronic conditions and behavioral health challenges is more detrimental than the sum of its parts. In fact, one recent study published by The New England Journal of Medicine found that chronic disease patients with mental health disorders not only cost nearly twice as much as their peers without mental health needs, but they also use more healthcare services. The study of hospitalization and physician billing claims for adults 18 years and over showed that chronic disease patients without a mental health disorder cost, on average, $22,280 during the period, while those with a mental health disorder cost $38,250[1].

Here are a few more sobering statistics to keep in mind that we shared during our recent webinar, “Unraveling the Impact of Behavioral Health on Chronic Conditions: Proof the Whole-Person Approach Works”:

  • Depression costs US businesses over $51 billion annually in absenteeism from work and lost productivity on top of $26 billion in direct treatment costs.[2]
  • Almost half of those who have one behavioral health disorder have two or more disorders.[3]
  • A majority—60%—of those who need behavioral health care are untreated.[4]
  • A third of people with chronic conditions also have an identified behavioral health condition.[5][6]
  • Co-occurring conditions are more expensive and have worse outcomes.[7]

It’s obvious that the traditional acute care model simply is not working for people with chronic conditions. People only spend 0.1% of their time in a healthcare setting; chronic conditions impact their lives all of the time. As people are expecting a more consumer-first experience in healthcare, they are frustrated by a system that leaves providers overwhelmed and under-resourced and unable to deliver the care and support necessary for the combined impact of chronic conditions and behavioral health challenges.

These challenges have inspired us to do more to effectively engage members through our platform. With our recent acquisition of myStrength, Livongo is now the industry leader in treating mental and behavioral challenges like stress, anxiety, and depression. By combining myStrength’s insights and capabilities with Livongo’s, we’re already doing more to drive real benefits to members who have chronic conditions and behavioral health challenges.

Doing more to effectively connect people is critical for success. Fortunately, the nature of our more connected world offers multiple opportunities to effectively support our members—and gather data about their health status—which is where our applied health signals feature comes into play. By tracking the information shared by members in real time across their devices, we are able to identify health needs or interventions before they are aware of an issue.

This whole-person approach started with diabetes management, but through the addition of MyStrength, we are now able to address depression, stress, chronic pain, anxiety, substance abuse, and insomnia. This means Livongo helps to not only prevent health from getting worse, we also help people manage their chronic conditions over their lifetime. We take a three-pronged approach to addressing this:

  • Identification: Increasingly accurate models are helping to make the identification of primary and secondary behavioral health needs less challenging.
  • Access: Limited resources can be optimized through predictiveness, and just-in-time adaptive interventions increase the likelihood of success.
  • Treatment quality: Addressing behavioral health or chronic care alone misses the most complex, most expensive, and most underserved population; personalization and flexibility in communication and treatment are critical to improving outcomes.

Our research shows that these consumer-focused solutions can do more to drive real improvements in health and incite positive behavioral changes in at-risk individuals. Optimization of our outreach communications has driven double-digit year-over-year increases in enrollment, meaning more members are served by our programs. In addition, by effectively aggregating and interpreting data from members, we provide tailored coaching and Health Nudges™ to reinforce positive behaviors. Our data scientists review the outcomes, and iterate to drive continuous improvement across our member base.

The intersection of chronic conditions and behavioral health demands new ways of approaching member interaction, engagement, and management. We must drive real change through cost-saving solutions that effectively engage members, and treat them as people, not as their conditions. We discussed strategies for addressing these challenges in our recent webinar, “Unraveling the Impact of Behavioral Health on Chronic Conditions: Proof the Whole-Person Approach Works,” which is now available for download. Take a look—we hope you’ll join us as we work to help our members live healthier lives.


[1] https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2748662?

[2] https://www.ncbi.nlm.nih.gov/pubmed/14728109

[3] https://www.apa.org/helpcenter/data-behavioral-health

[4] https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.htm#tab8-33A

[5] https://www.thelancet.com/commissions/physical-health-in-mental-illness

[6] https://www.cdc.gov/workplacehealthpromotion/tools-resources/pdfs/issue-brief-no-2-mental-health-and-chronic-disease.pdf

[7] https://www.pwc.com/us/en/industries/health-industries/health-research-institute.html

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