Each year, we evaluate our Behavioral Complex Case Management Program to ensure we’re delivering meaningful support and meeting accreditation standards. We are pleased to share key insights from the Evernorth^® Behavioral Health evaluation for 2025, reflecting our continuous commitment to improving outcomes for your patients.

2025 key findings

Performance metrics

We tracked several metrics to evaluate the program’s effectiveness:

• Customer satisfaction: 94% (Goal: 90%)
• Reach rate: 35% (Goal: 38%)
• Engagement rate: 26% (Goal: 30%)
• Completion rate: 92% (Goal: 92%)

Patient screening insights

We assessed the results for depression and substance use screenings.

Patients screening positive for:

• Moderate depression: 29%
• Severe depression symptoms: 6%
• Substance use: 21%

Top referral sources

The highest number of referrals come from the following sources:

• Utilization management process
• Hospital discharge information
• Claims information

Most referred programs

The highest number of referrals are for the following programs:

• Coaching and Support for Substance Use Disorders
• Coaching and Support for Autism
• Intensive Behavioral Case Management

What’s new: Program enhancements

Over the past few years, we’ve made targeted enhancements to strengthen outreach and increase impact for your patients, including:

• Expanded access hours to match customer behavior and needs.
• Streamlined operations, so customers can transition smoothly from an initial clinical connection to ongoing coaching and case management.
• Increased support for case managers to allow more time to build meaningful connections with customers.
• Continued exploration of new tools and proof-of-concept initiatives to further enhance support.

These changes are helping us reach more individuals and deliver more personalized, coordinated support.

About our Behavioral Complex Case Management Program

Our program is designed to help your patients better understand their behavioral health conditions, remain engaged in treatment, and adhere to their care plans. We use a centralized approach that employs standardized tools and metrics across all clinical areas to ensure quality and consistency.

Case management plans are customized for each individual and developed in collaboration with their treating provider, involving patients and their families as appropriate. Referrals to the program come from a variety of sources, including:

• Hospital discharge data.
• Pharmacy and claims information.
• Utilization management.
• Employer groups, customers, and behavioral health providers.

We use validated screening tools like the Patient Health Questionnaire-9 (PHQ-9) for depression and the CAGE-AID for substance use to identify needs and guide care.

Need support or have questions?

To learn more about our behavioral coaching and case management services, or to check a patient’s eligibility, please call the telephone number on the back of their ID card.

If you have questions about the Behavioral Complex Case Management Program, call the Evernorth Behavioral Health Provider Relations team at 800.926.2273 or visit the EvernorthProvider portal (Provider.Evernorth.com).