Data Insights: Analysis Reveals Increase in High-Risk Members with Depression

A new analysis from Cedar Gate Technologies, an IQVIA Business (Cedar Gate), reveals that the rate of high-risk members — defined as members likely to incur higher-than average healthcare costs due to existing risk factors — who have depression grew by 8.65% last year. That increase occurred despite the total number of people diagnosed with depression declining by 6.47% in the same time period. In total, nearly 11% of members analyzed had a diagnosis of depression as a chronic condition. Almost one in five of those diagnosed (19%) are considered high risk.

The analysis utilized 2024 data from our National Healthcare Benchmark Database, which includes data from millions of commercially insured members across the country. All information is completely de-identified to protect patient privacy and comply with HIPAA law.

“Behavioral health is a significant cost driver in healthcare, so having the ability to surface patients and members with higher-than-average risk is an important tool to align appropriate care with risk,” said Joseph Siemienczuk, MD, Medical Advisor for Clinical Solutions at Cedar Gate. “Proactive intervention not only helps reduce costly care, it also improves outcomes for patients who struggle with mental health disorders, including depression, anxiety, and other chronic mental health conditions.”

Other findings from the analysis revealed that the number of people diagnosed with depression who also have a primary diagnosis of anxiety or mood disorders is on the rise, increasing 3.9% from 22.3% in 2023 to 26.2% in 2024. Additionally, more than 50% of people diagnosed with depression as a chronic condition have two or more other diagnosed chronic conditions. Depression is most common among young adults, with members aged 20–39 experiencing depression at rates more than 40% higher than members aged 60-64.

Depression is one of the most common mental disorders in the U.S, affecting about one in six adults and often occurring in tandem with anxiety and other chronic health conditions.

To identify high-risk members with depression, our Value-Based Care Analytics application calculates a proprietary prospective risk score that indicates the potential for someone to incur higher-than-average costs in the coming 12 months. It evaluates medical and pharmacy claims using the Milliman MARA Cx model, factoring in both acute and chronic clinical risk factors as well as demographics, to arrive at a standardized risk score. Organizations can use this information to identify members who would benefit from earlier, more proactive intervention.

Learn more about Cedar Gate’s full analytics capabilities: Value-Based Care Analytics