Section I Executive Summary of Findings... Page 2. Section II Methodology... Page 4
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1 Table of Contents SAMPLE Section I Executive Summary of Findings... Page 2 Section II Methodology... Page 4 Section III Behavioral Health Management Market Statistics, Page 6 Section IV Managed Behavioral Health Program Enrollment Statistics... Page 16 A. Managed Behavioral Health Program: Risk Based Enrollment Statistics... Page 24 B. Managed Behavioral Health Program: ASO Enrollment Statistics... Page 29 C. Utilization Review/Case Management Programs Enrollment Statistics... Page 32 Section V Employee Assistance Program Enrollment Statistics... Page 35 A. Employee Assistance Only Program Enrollment Statistics... Page 43 B. Integrated Managed Behavioral Health/Employee Assistance Program: Risk Based Enrollment Statistics... Page 47 C. Integrated Managed Behavioral Health/Employee Assistance Program: ASO Enrollment Statistics... Page 49 D. Integrated Employee Assistance Work Life Program Enrollment Statistics... Page 51 Section VI Work/Life Assistance Program Enrollment Statistics... Page 53 Section VII Disease Management Program Enrollment Statistics, Page 57 A. Disease Management Program (Behavioral Health Disorders) Enrollment Statistics... Page 62 B. Disease Management Program (Chronic Diseases Not Behavioral Health) Enrollment Statistics... Page 64 C. Disease Management Program (Acute Care) Enrollment Statistics... Page 66 Section VIII Directory of Behavioral Health Management Organizations... Page 68 Section IX Glossary of Terms... Page 431 Section X Index... Page 436 Table of Contents Page 1
2 Tables, Charts & Graphs Tables: Enrollment By Program Type, 2002 & Managed Behavioral Health Programs... 6 Employee Assistance Programs... 7 Specialty Disease Management Programs... 8 Top 20 Organizations With Largest Market Share In Managed Behavioral Health, Employee Assistance & Work/Life Assistance Programs, By Total Enrollment, Specialty Disease Management Program Market Share, By Enrollment, 2011: Top 10 Organizations... 9 Organizations By Total Managed Behavioral Health, Employee Assistance Program, & Work/Life Assistance Program Market Share, Largest Organizations By Total Enrollment In Behavioral Health Management Market, Top 20 Organizations With Largest Total Market Share In Managed Behavioral Health Programs By Total Enrollment (In Millions) & Market Share, Top 20 Organizations With Largest Market Share In Managed Behavioral Health Programs: Risk Based By Total Enrollment (In Millions) & Market Share, Top 20 Organizations With Largest Market Share In Managed Behavioral Health Programs: Administrative Services Only By Total Enrollment (In Millions) & Market Share, Top 20 Organizations With Largest Market Share In Utilization Review/Case Management Programs By Total Enrollment (In Millions) & Market Share, Organizations By Total Managed Behavioral Health Program Market Share, Organizations By Total Managed Behavioral Health Program: Risk Based Market Share, Organizations By Total Managed Behavioral Health Program: Administrative Services Only (ASO) Market Share, Organizations By Total Utilization Review/Case Management Managed Program Market Share, Top 20 Organizations With Largest Total Market Share In Employee Assistance & Work/Life Programs By Total Enrollment (In Millions) & Market Share, Top 20 Organizations With Largest Market Share In Employee Assistance Only Programs By Total Enrollment (In Millions) & Market Share, Top 16 Organizations With Largest Market Share In Work/Life Programs By Total Enrollment (In Millions) & Market Share, Top 20 Organizations With Largest Market Share In Integrated EAP/Work Life Programs By Total Enrollment (In Millions) & Market Share, Top 13 Organizations With Largest Market Share In Integrated EAP/Managed Behavioral Health Programs: Risk Based By Total Enrollment (In Millions) & Market Share, Top 20 Organizations With Largest Market Share In Integrated EAP/Managed Behavioral Health Programs: ASO By Total Enrollment (In Millions) & Market Share, Organizations By Total Employee Assistance Program Market Share, Organizations By Employee Assistance Only Programs Market Share, Organizations By Total Work/Life Assistance Programs Market Share, Organizations By Total Integrated Employee Assistance/Work Life Programs, Organizations By Total Integrated EAP/Managed Behavioral Health Programs: Risk Based, Market Share, Table of Contents Page 2
3 Organizations By Total Integrated EAP/Managed Behavioral Health Programs: ASO, Top 20 Organizations With Largest Total Market Share In Specialty Disease Management Programs By Total Enrollment (In Millions) & Market Share, Top 10 Organizations With Largest Market Share In Disease Management Programs (Behavioral Health Disorders) By Total Enrollment (In Millions) & Market Share, Top 10 Organizations With Largest Market Share In Disease Management Programs (Chronic Diseases Not Behavioral Health) By Total Enrollment (In Millions) & Market Share, Top 5 Organizations With Largest Market Share In Disease Management Programs (Acute Care) By Total Enrollment (In Millions) & Market Share, Organizations By Total Specialty Disease Management Program Market Share, Organizations By Total Disease Management Program (Behavioral Health Disorders), Organizations By Total Disease Management Program (Chronic Diseases Not Behavioral Health), Organizations By Total Disease Management Program (Acute Care), Behavioral Health Management Programs Surveyed In 2002 Compared To Charts & Graphs: Total Enrollment In Managed Behavioral Health Programs By Product Line, Total Enrollment In Managed Behavioral Health Programs By Year, In Millions Of Covered Lives, Total Enrollment In Managed Behavioral Health Programs: Risk Based By Year, In Millions Of Covered Lives Total Enrollment In Managed Behavioral Health Programs: Administrative Services Only By Year, In Millions Of Covered Lives Total Enrollment In Utilization Review/Case Management Programs By Year, In Millions Of Covered Lives Top 10 Organizations With Largest Total Market Share In Managed Behavioral Health Programs, Top 10 Organizations With Largest Managed Behavioral Health Program: Risk Based Market Share, Top 10 Organizations With Largest Managed Behavioral Health Program: Administrative Services Only Market Share, Top 10 Organizations With Largest Utilization Review/Case Management Program Market Share, Total Enrollment By Product Line In Employee Assistance & Work/Life Programs, Total Enrollment In Employee Assistance & Work/Life Programs By Year, In Millions Of Covered Lives, Total Enrollment In Employee Assistance Only Programs By Year, In Millions Of Covered Lives, Total Enrollment In Integrated EAP/Managed Behavioral Health Programs By Year, In Millions Of Covered Lives, Top 10 Organizations With Largest Total Market Share In Employee Assistance Programs, Top 10 Organizations With Largest Market Share In Employee Assistance Only Programs, Top 10 Organizations With Largest Market Share In Work/Life Assistance Programs, Top 10 Organizations With Largest Market Share In Integrated Employee Assistance/ Work Life Programs, Top 10 Organizations With Largest Market Share In Integrated EAP/Managed Behavioral Health Programs: Risk Based, Top 10 Organizations With Largest Market Share In Integrated EAP/Managed Behavioral Health Programs: ASO, Total Enrollment By Product Line In Specialty Disease Management Programs, Top 10 Organizations With Largest Total Market Share In Specialty Disease Management Programs, Top 10 Organizations With Largest Disease Management Program (Behavioral Health Disorders), Top 8 Organizations With Largest Disease Management Program (Chronic Diseases Not Behavioral Health), Top 5 Organizations With Largest Disease Management Programs (Acute Care), Table of Contents Page 3
4 Section VI. Methodology Section VI: Methodology Page 442
5 Methodology OPEN MINDS identified over 700 organizations involved in the delivery of managed behavioral health, EAP, Work/Life, and disease management programs between the period 2002 and These programs were researched and surveyed for their current market involvement, including demographic and enrollment information. The combined effect of changes in service line offerings, and industry integration and consolidation, brought this year s final number of surveyed organizations to 361. To determine enrollment, OPEN MINDS surveyed identified organizations for the number of covered lives they served by service line in the United States as of January 1, Covered lives were defined as primary members plus dependents. Enrollment in companies acquired by others in the field since 2002, and enrollment in subsidiaries of larger managed behavioral health organizations were assumed to be captured in reporting by their parent companies. The shift toward increased integration of behavioral health service lines combined with the adoption of new service management models required inclusion of additional programs for evaluation. To best capture these market changes, we increased the number of programs evaluated from five in 2002 to eleven in 2011 (see the table below). Definitions for these programs can be found in the glossary (Section VII). Over 88% of this year s total enrollment was self reported by surveyed organizations. When organizations did not provide enrollment data, OPEN MINDS estimated their enrollment using publicly available data. These estimates were built on information found on organization web sites, SEC reports filed by publicly held organizations, and general internet research. All organizations were given the opportunity to review and comment on any estimate generated by OPEN MINDS. If enrollment information is estimated, it is indicated in the tables that follow with an asterisk (*). Behavioral Health Management Programs Surveyed In 2002 Compared To 2011 Surveyed Programs EAP only programs Work/Life Assistance programs Integrated EAP/Work Life Assistance programs Utilization Review/Case Management programs (prospective) Managed Behavioral Health: Risk Based Managed Behavioral Health: Administrative Services Only (ASO) Integrated EAP/Managed Behavioral Health: Risk Based Integrated EAP/Managed Behavioral Health: ASO Disease Management Programs (behavioral health disorders) Disease Management Programs (chronic diseases, not behavioral health) Disease Management Programs (acute care) Section VI: Methodology Page 443
6 Even with careful reporting by participating companies, double counting results. Service line integration and expansion since 2002 have resulted in covered lives being represented over multiple service lines, which complicates the reporting of unique lives. Covered lives may also have been calculated and reported differently by different companies. Although double counting has inflated total enrollment numbers by service line, we believe that enrollment numbers accurately reflect the distribution of enrollment across and within the industry. What follows is our summary of relevant market statistics, comparisons in market share changes from year to year, and a directory of organizations providing specialty managed behavioral health, employee assistance, and disease management programs in the United States. Section VI: Methodology Page 444
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