Mental Health Now Leading Comorbidity for Highmark Members


Highmark Wholecare reports that more than a third of its members have been diagnosed with at least one mental health condition.

That’s according to a recent analysis of more than 420,000 Highmark Wholecare members, which found that mental health disorders have become the most common health condition among its members, surpassing common conditions such as diabetes, hypertension, tobacco use, and obesity.

The Pennsylvania-based health plan has a network of more than 29,000 providers and offers Medicaid and Medicare programs. Its parent company, Highmark Health, recently signed a deal with Spring Health to give its members access to Spring’s in-person and virtual therapy, medication management, and 24/7 crisis support.

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“While we know that mental health is improving across the country, seeing the data that tells us it’s the number one indicator to predict the health and well-being of our members is alarming,” John Pepper, a spokesperson for Highmark Wholecare, said in a statement. “This is why we are focused on behavioral health education for providers and have recently funded additional programs that have been proven to promote the health and well-being of our most at-risk members.”

Severe persistent mental illness (SPMI) was the most common comorbidity, with anxiety and depression both in the top 10 most common.

The use of the term SPMI has been questioned due to the lack of a standard definition, but it is often used as an umbrella term for diagnoses including schizophrenia, depression, and bipolar disorder.

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Mental illnesses like these affect physical health and vice versa, according to the CDC. Depression, for example, increases the risk of conditions such as diabetes, heart disease, and stroke.

The study also compared data from the first quarter of 2020 to the third quarter of 2023 to compare rates of mental health disorders from before the pandemic to now. All populations of Highmark Wholecare members experience an increase in mental health conditions. However, dually eligible members who qualify for Medicare and Medicaid due to age, disability, or both experienced an 8.5% increase.

To combat these higher rates of mental health disorders, Highmark Wholecare launched a pilot program called the Brain Health Initiative, designed to provide its members who qualify for Medicare and Medicaid with customized lifestyle interventions to prevent Alzheimer’s and dementia.

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