The advisory firm’s Health Research Institute estimated medical costs will rise 8% in the group commercially insured market in 2025.
Rising utilization of behavioral health services, prescription drug spending and inflationary pressures are the three main factors behind the increase, according to PwC’s report, published in July.
Behavioral health accounted for 3.8% of medical claims in 2023, up from 1.8% in 2018, according to PwC. Insurers spent an average of $122.79 per behavioral health claim in 2023, up from $106.84 in 2018.
In 2025, providers should continue to address patients’ behavioral health needs while managing financial impact on their practices, according to PwC. The report recommended providers invest in specialized training for clinicians to address behavioral health needs, and explore alternative payment models for behavioral care.
Employers may face “difficult decisions” regarding behavioral benefits and cost-sharing for employees in 2025, PwC analysts wrote.
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