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Our country is in the throes of a mental health crisis that we are ill-equipped to manage. This has created a monumental and still-intensifying financial burden for employers who, in our current healthcare system, assume more than 80% of the cost of care on behalf of their employees. Sadly, the mental health tsunami has yet to crest—which is why business leaders MUST make big changes now, or suffer catastrophic consequences.

The cost of addressing the crisis pales in comparison to the cost of inaction, in both human and financial terms. Employees with unresolved depression experience a 35% reduction in productivity and an average of 31 days of missed work per year. This absenteeism translates to $210.5 billion in annual losses to the U.S. economy, not to mention the increased medical costs associated with untreated mental illness. And the impact on individual employees and their families offers perhaps the grimmest statistics of all. Half of adults report a severe mental health crisis in their families, and one in five cite the inability to work or engage in other activities due to poor mental health. We have all been affected by this crisis; as a leader, you have the power to make a difference.

The challenge is stark, and it is complicated by two opposing forces. As an employer, you have a clear moral and financial obligation to address your employees’ mental health needs; however, with a fixed pool of money available for employee health and wellness benefits, spiraling costs across all facets of healthcare impede your ability to do so.

Thus, the conversation about mental and behavioral health is really one about the holistic healthcare needs of your employee population, and how to meet those needs while mitigating waste and containing costs. And that requires you to radically shift your understanding about what a healthcare benefits partner can and should deliver. It’s not about increasing your financial allocation for benefits; rather, you must ensure that you are maximizing savings across medical, pharmacy, and all other benefit categories to create the financial headroom to tackle your employees’ mental health needs head-on.

As a business leader, it’s time for you to start using your contributions as leverage to demand more from your healthcare benefits partners. You must reset the expectations placed on your Health Plan and your Pharmacy Benefits Manager (PBM). Blindly agreeing to the status quo—substandard benefits and increasing costs—is handcuffing you from doing what’s right by your employees and your bottom line. You are not an innocent bystander; employers have the power in numbers to influence change, and you must do so now.

Here’s what reclaiming power over your healthcare benefits requires of you and your organization:

• Demand guaranteed, sustainable savings—not one-off incentives. The moment demands transformational changes to your benefits spend, and that requires a contractual model that both optimizes your existing spend and delivers sustainable savings at that reduced level. Incentives or rebates are fast fixes, but do nothing to free up operating capital long-term to address the crisis.
• Don’t fall into the transparency trap. Despite what you may have read, price transparency is not the cure for what ails the benefits marketplace. Transparent drug pricing won’t bend the cost curve without a fundamentally different paradigm for attacking the problem. Put simply, the promise of a glass box is irrelevant when the problem is overall cost structure, not unit level pricing.
• Expect 100% financial alignment. So-called solutions that single-mindedly focus on drug unit pricing are deeply misaligned with your organization’s interests. Contractual models based on unit costs intrinsically boost volume, thereby driving up overall costs. By contrast, a value-based model prioritizes both financial and health outcomes and serves as the gold standard of what financial alignment looks like.
• Reject the cost-versus-access dichotomy. Focus on value. Fundamentally, this is a conversation about the health and well-being of your employees; cost-savings at the expense of access to care is not a trade-off worth making, nor is it necessary in a value-based paradigm. Demand improved cost, broad access, and enhanced care models, and demand value. Do not compromise on any of these points.

Business leaders cannot sit idly by as we begin 2023 amidst immense business, economic and social challenges. We must take seriously any challenge that threatens the health and safety of our employees, and we must do so while protecting our bottom line. Shore up your finances to create the necessary financial conditions to prioritize support for mental health, before the tsunami washes the ground from under you. And expect that your healthcare benefits partners help you weather the storm.

Leaders: The time for inaction is over. Now is the time for you to reclaim power over your health benefits and recoup the complete value of your healthcare spend. Do it for the health and safety of your employees.