Aetna Disability Study Shows Members May Get Back to Work Sooner Following Mental Health Leave

-- Aetna’s disability behavioral health management program helps members return to work and achieve optimal health --

HARTFORD, Conn.--(BUSINESS WIRE)-- A recent study by Aetna (NYSE:AET) Disability and Absence management of disability members who also had a mental health diagnosis showed that members spent an average of seven fewer days on disability when compared to an industry benchmark.* The Aetna Disability program is unique among disability providers in that it contains its own centralized Behavioral Health Unit (BHU) staffed with licensed behavioral health clinicians. Professionals with experience in the behavioral health field are better able to manage the clinical aspects of psychiatric disability claims, promoting prompt case resolution and improved patient outcomes.

“Many behavioral health conditions are common and treatable disorders,” said Adele Spallone, LMHC, LMFT, head of Clinical Services for Aetna Disability and Absence Management. “Our goal is to identify those suffering with mental health disorders early and assist them through the disability process. For us the emphasis is not just returning members to work, but returning them to optimal health – both physically and mentally.”

Depression is the second leading cause of disability worldwide according to the World Health Organization. Mental health disorders are the third most expensive economic burden of illness to employers in the United States, according to a 2004 report by the Journal of Occupational and Environmental Medicine.

Aetna’s study assessed short-term disability claims for 15 mental health disorders. The largest improvement over the industry benchmark occurred for people with Depressive Disorder NOS (Not Otherwise Specified), Major Depression (Recurrent), Adjustment Reaction and Dysthymic Disorder, a chronic form of depression.

Aetna’s Disability Behavioral Health Unit was designed to address the high volume and complexity of psychiatric and psychological disabilities. Claims accepted by this unit have a mental health diagnosis or psychiatric component that may impact the claimant’s health recovery and ability to return to work. The mental health diagnosis can be the primary or secondary diagnosis or a psychosocial component, which may impact the disability claim. Using proactive member and provider outreach strategies and tracking clinical progress, clinicians are able to engage members and physicians more fully in both care and rehabilitation. The integration of behavioral health knowledge and disability case management, along with proactive outreach and member engagement, has been shown to result in earlier intervention, an increase in coordination of services, and faster, appropriate claim resolution.

Aetna’s Disability Behavioral Health Unit staff is composed of 37 licensed master’s-level social workers, mental health counselors and psychiatric nurses. During calendar year 2008, the Disability Behavioral Health Unit clinically managed a total of 9,052 claims. These professionals developed and use a clinical model with specific analytical tools to determine the severity of a member’s condition, and whether it warrants disability leave from work or more serious treatment.

Aetna’s Disability Behavioral Health clinicians work with the member’s physician to further understand the extent of his or her depressive symptoms. They also work with members on disability leave to address quality-of-care concerns, set a time line for expected recovery and assist in the development of return-to-work-plans.

*Aetna data compared with 2008 Medical Disability Advisor (MDA) duration data published by the Presley Reed Group.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 36.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com.

Aetna
Kate Prout, 215-348-2691
[email protected]

Source: Aetna