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 2024, reflecting our continuous commitment to improving outcomes for your patients.

2024 key findings

Performance metrics

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

• Customer satisfaction: 96% (Goal: 90%)
• Reach rate: 38% (Goal: 35%)
• Engagement rate: 32% (Goal: 30%)
• Completion rate: 92% (Goal: 88%)

Patient screening insights

We assessed the results for depression and substance use screenings:

• Patients screening positive for moderate depression: 28%
• Patients showing severe depression symptoms: 6%
• Patients screening positive for substance use: 29%

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 Parents and Families
• Intensive Behavioral Case Management

What’s new: Program enhancements

Over the past few years, we’ve implemented a variety of enhancements to the Behavioral Complex Case Management Program aimed at improving outreach and making a greater impact for your patients, such as:

• Streamlining operations to minimize duplication and boost efficiency.
• Providing increased support for case managers to allow more time to build meaningful connections.
• Continuing our exploration of new tools and proof-of-concept initiatives.

These changes are helping us reach more individuals and deliver more personalized 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 Provider.Evernorth.com.