Actuaries Play an Important Role in Behavioral Health Care, Now and in the Future

By Matthew Williams 
Senior Policy Analyst, Health 

As autumn is in full swing, Americans are increasingly preparing for a busy end of the year. While the end of the year is thought to be a joyous period for spending time with family and friends, some people may feel down or depressed.  

This may be due to the very common phenomenon known as winter-pattern seasonal affective disorder (SAD), caused by lower outside light levels in the late autumn and winter months. According to the National Institute of Mental Health (NIMH), SAD shouldn’t be confused with the “holiday blues,” which are described as feelings of sadness or anxiety brought on by stresses during this time of year. Rather, SAD is a common form of depression that can affect many people. It can be coupled with such symptoms as overeating, oversleeping, and withdrawal from social activities.  

Experiencing a depressive episode is not uncommon. In fact, the National Alliance on Mental Illness (NAMI) finds that 1 in 5 U.S. adults experience mental illness in a given year. These episodes not only impact the professional and personal lives of the individual directly, they also impact friends, families, employers, and caregivers. With so many experiencing these events, efforts continue to improve broader awareness of what mental illness is to address the stigma that may follow a diagnosis, and to overcome any hesitation by those who may be seeking help.  

The pervasiveness of the disease and the impact it has on both the health of the population and the financial health of consumers and employers makes the issue of behavioral health particularly ripe for the Academy and the Health Practice Council’s public policy work. Recognizing the impact mental health has on overall health, the Academy formed the Behavioral Health Task Force (BHTF) in 2023. The BHTF is currently working closely with the HPC’s Health Equity Committee (HEC), given the overlap between the public policy discussions around health equity’s impact on overall health and the specific implications equity has on access and affordability in the behavioral health and substance use disorder space. 

 A strategic priority in 2025, the two groups will be applying an actuarial lens to pricing and benefit design implications when considering equity and behavioral health, as well as the implications that consumers, policymakers, and industry must consider as we continue to better integrate behavioral health care with primary health care. Anticipating a follow-up to the 2023 Health Equity Symposium, the HPC is also looking at bringing together external stakeholders and actuaries to discuss issues around behavioral health provider/workforce shortages. It will examine the implications of proposals related to provider payment and incentives reform, as well as cross-state licensure and the expansion of telehealth services across states and within rural areas. 

Additionally, focus will be given to network adequacy and changes to and the regulatory focus on mental health parity laws. It’s also important to consider implications not only for the commercial space, but also within public programs like Medicare and Medicaid, which have some different considerations in terms of program costs and coverage.  

In an effort to better understand the current landscape and where there are opportunities for the Academy and our members to engage in these discussions, the BHTF and HEC have been hosting a “behavioral health listening tour.” This tour has led our volunteers and leadership to meet with various organizations and governmental agencies, asking them where they see emerging issues and opportunities to interject actuarial perspective and expertise. 

The new year will bring additional papers and presentations, focusing on trends in the market in order to keep Academy members, insurance regulators, industry, employers, and other key stakeholders informed. The Academy’s website will continue to highlight the work and engagement that the HPC is doing in this space. We’ll also be opening registration for a variety of health-related events, including our Fall 2025 behavioral health-focused symposium, in the months ahead.