- Blue Cross Blue Shield Insurance Coverage for Eating Disorder Treatment and Rehab
- Does Blue Cross Blue Shield Insurance Cover Treatment for Eating Disorders?
- Type of Rehabs Blue Cross Blue Shield Insurance Will Pay For
- How Much of the Cost is Covered by Blue Cross Blue Shield?
- Can I Cover Above What Blue Cross Blue Shield Will Cover to Receive Treatment?
- What Treatment Lengths Will Blue Cross Blue Shield Pay For?
- Eating Disorder Inpatient Therapy vs. Outpatient Therapy
- Should I Choose a Residential Rehab Center?
- Will Blue Cross Blue Shield Pay for Local Rehab and State Treatment?
- Does Blue Cross Blue Shield Pay for Private or Luxury Treatment?
- What Does Executive Treatment Offer Over Other Rehabs?
- What if I Have No Insurance?
- Questions and Answers
- Using Aetna for Eating Disorder Treatment
- Will Aetna Cover Eating Disorder Treatment?
- How Much Will Eating Disorder Treatment Cost?
- Inpatient Eating Disorder Treatment vs. Outpatient Services
- Dual Diagnosis Eating Disorder Therapy
- Insurance vs. Private Pay for Eating Disorder Options
- The unexpected costs of eating disorders
- Eating Disorders: The Cost
- Gold Standard Treatments Are Time and Cost-Efficient
- Extensive Programming Is Not Always Necessary
- Behavior Change – Early On
- Alternative To Hospitalization for Kids and Teens
- The Bottom Line
- What Resources Are Available to Help Me Cover The Cost of Eating Disorder Treatment?
- The Necessity of Professional Treatment
- Organizations and Resources
- Cost analysis of inpatient treatment of anorexia nervosa in adolescents: hospital and caregiver perspectives
- The Dollars and Cents of Eating Disorders
Blue Cross Blue Shield Insurance Coverage for Eating Disorder Treatment and Rehab
The best way to learn about the details of your coverage is to call Blue Cross Blue Shield so that you know exactly what your out-of-pocket costs will be.
The good news is that the majority of Blue Cross Blue Shield Insurance plans provide at least partial coverage for the treatment of eating disorders, such as bulimia and anorexia.
The extent of coverage can vary according to state and individual plan.
(Please note: Rehabs.com strives to provide you with the most updated information on each carriers’ addiction insurance coverage but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels. Rehabs.com is an informational site only and is not affiliated or sponsored by Blue Cross Blue Shield.)
Does Blue Cross Blue Shield Insurance Cover Treatment for Eating Disorders?
Statistics show that up to 24 million people suffer from an eating disorder, such as anorexia, bulimia or a binge eating disorder.
Blue Cross Blue Shield insurance is administered by different providers across the country, so coverage varies according to the state, specific provider, and individual plan.
Many plans do offer at least partial coverage for treatment related to eating disorders, as this is an important component of a person’s mental and physical health.
Type of Rehabs Blue Cross Blue Shield Insurance Will Pay For
The policies that individuals have with Blue Cross Blue Shield can vary significantly. In general, this medical coverage provider does offer provisions for mental illness, which often include eating disorders.
The rehabs covered under your plan might include inpatient or outpatient treatment centers, so consult your plan administrator or policy documents for details.
Though it is unly, some plans may cover luxury treatment or executive treatment plans.
How Much of the Cost is Covered by Blue Cross Blue Shield?
Again, every Blue Cross Blue Shield policy is different in terms of coverage levels and how much of the cost they will absorb.
If you are receiving medically necessary treatment, it is ly that at least a portion of your costs will be covered by Blue Cross Blue Shield. Medical coverage providers also update their policies frequently.
It is important for the policyholder to review what their individual policy specifies. In some cases, treatment relating to eating disorders may fall under the mental health category.
If left untreated, eating disorders can lead to some serious physical consequences. The length of the illness and resulting physical effects will dictate the level of treatment that is needed. Treatment could include counseling, intensive outpatient therapy, hospitalization and a stay in a rehab designed to address this health issue.
Can I Cover Above What Blue Cross Blue Shield Will Cover to Receive Treatment?
Many patients who suffer from eating disorders want the best eating disorder rehab program available to them. In these cases, you absolutely can pay pocket above what Blue Cross Blue Shield will cover. This is especially true if you’re interested in luxury or executive treatment or other special treatments.
What Treatment Lengths Will Blue Cross Blue Shield Pay For?
Your specific policy will dictate what level of coverage you have, including the length of treatment Blue Cross Blue Shield will cover.
Blue Cross Blue Shield may cover, at least partially, any length of treatment and aftercare that is deemed medically necessary; however, it’s always best to check your specific plan.
Treatments most often last 1 month, 2 months, or 3 months. Other special treatments, such as therapeutic communities, may last longer.
any other medical problem, eating disorders differ greatly in each person it affects. Length of treatment is the individual needs of the person suffering with this problem. There are also different types of eating disorders, and each type has a specific time demand for successful treatment.
Eating Disorder Inpatient Therapy vs. Outpatient Therapy
“Statistics show that up to 24 million people suffer from an eating disorder, such as anorexia, bulimia or a binge eating disorder.”
Since there is a high risk of physical complications arising from eating disorders bulimia or anorexia, inpatient therapy in a hospital setting may be the best option for a patient.
Inpatient therapy sequesters patients away from triggers and other issues that may affect his disorder, giving him a chance to relax and focus on healing. Once a patient has recovered, he often continues treatment as an outpatient, during which he visits a facility for treatment but lives at home.
For less severe cases, it’s also possible for someone to start as an outpatient.
Should I Choose a Residential Rehab Center?
If you are suffering from an eating disorder, you should speak with your doctor or medical consultant to decide which treatment will be best for you. It is important that you choose a treatment you are comfortable with. Some individuals feel that being in a controlled setting a residential rehab center would give them a greater chance of dealing with their disorder.
Will Blue Cross Blue Shield Pay for Local Rehab and State Treatment?
You would need to refer to your specific policy to see exactly what it covers and whether it will give you the option of seeking out-of-state treatment.
Regardless of location, sticking with a treatment center that’s considered in-network for your particular plan will give you the greatest level of coverage.
Eating disorders are becoming far more recognized as a serious problem; because of this, there are more treatment options and rehab centers offering quality treatment for these disorders in many convenient locations.
Does Blue Cross Blue Shield Pay for Private or Luxury Treatment?
If you think private or luxury treatment would be beneficial for overcoming your disorder, speak with Blue Cross Blue Shield to see if it will cover any part of this treatment.
Most ly it will not cover the full cost, but it may cover part of it, depending on your plan.
If you think the amenities offered by these treatment programs will help you get healthy, consider paying pocket or discussing a payment plan with the specific facility.
What Does Executive Treatment Offer Over Other Rehabs?
Eating disorders do not just target a specific type of person, profession or gender. Executives who suffer with this disorder may opt for a rehab that caters to their professional needs. Treatment may focus on the type of daily atmosphere that an executive has to deal with on a daily basis; moreover, executive treatment will allow executives to continue necessary work.
What if I Have No Insurance?
Treatment costs differ according to the specific program. You may want to first look at those eating disorder treatments that offer a good program within your price range. Then secondly, think about utilizing those treatment centers that offer flexible payment options.
Questions and Answers
- Will Blue Cross Blue Shield Cover Multiple Stays?
It is not unusual for an individual suffering with an eating disorder to relapse or require more help. Your individual policy will determine just how much coverage is available for repeat treatments. If treatment is medically necessary, you will ly receive more coverage.
- Does Insurance Pay for Aftercare?
Insurance might pay for aftercare services if it is medically necessary for you overcoming your disorder.
- Could Rehab Make my Insurance Higher?
Plan costs are typically set for a period of at least a year, so you should not need to worry about any immediate change in rates. Regardless, worrying about future coverage should not deter you from seeking the help you need to get healthy now.
- Has the Affordable Care Act (Obamacare) Affected Substance Abuse and Mental Health Insurance Coverage?
Obamacare has outlined that mental illness count as essential coverage. Effectively, Obamacare has expanded substance abuse and mental health insurance coverage.
Using Aetna for Eating Disorder Treatment
With over 22 million members, Aetna is one of the largest health insurance providers in the United States. It offers many different health insurance plans, primarily through employers. If you are considering getting treatment for an eating disorder, the following guide will help you navigate the complexities of using Aetna for eating disorder treatment.
There are several different types of eating disorders, including anorexia nervosa, bulimia nervosa and binge eating disorder, but they are all characterized by an obsession with food, weight and appearance. Someone with an eating disorder may experience any or all of the following symptoms:
- Refusal to eat or eating to the point of discomfort or pain
- Negative or distorted self-image
- Excessive exercise
- Preoccupation with food
- Social withdrawal
- Irregular heart rhythms
- Extreme weight loss
Statistics show that 95 percent of those with an eating disorder fall between the ages of 12 and 25, which means many of them are adolescents who are still living at home. If you are concerned that one of your children or another loved one is struggling with an eating disorder, here are some red flags to look out for:
- Skipping meals or adopting food rituals at mealtimes, such as cutting food up into small pieces or only eating very specific foods
- Persistent worries related to body image and appearance
- Not wanting to eat in public
- Food hoarding or eating in secret
- Withdrawing from social activities
- Having a distorted body image or making constant complaints about weight
- Making excuses for not eating
Remember that the earlier you get treatment, the better your prospects for recovery, so if you are concerned that you or a loved one may have an eating disorder, call us at as soon as possible. Our friendly representatives are standing by to take your call.
When you are using Aetna for eating disorder treatment, you do not need to get a referral from your primary care physician, but you do need to find a provider in the Aetna network. Call the behavioral health number on the back of your insurance ID card, and a clinical care manager will assess your current situation and help you find a qualifying provider.
Individual plans will vary in regards to specific coverage, limits and expected out-of-pocket expenses, so be sure you have a good understanding of what your plan covers before embarking on a course of treatment.
In general, Aetna insurance coverage plans may fully or partially cover inpatient services, including counseling and therapeutic services, in a hospital or residential facility, and short-term evaluations and interventions on an outpatient basis.
Each of these services is subject to limits, so check your individual plan for specific information.
If you are in an emergency situation, you should call your primary care physician if possible. Otherwise, your doctor should be notified as soon as possible and coordinate all follow-up care. Be aware that the plan does not cover nonemergency use of the emergency room.
Will Aetna Cover Eating Disorder Treatment?
Aetna will cover all treatments that are medically necessary, but your plan may not cover the entire length of treatment that is recommended.
Managing an eating disorder is often a long-term and intensive process that involves a multidisciplinary team of medical professionals. Usually, a medical doctor, psychologist, psychiatrist and nutritionist are needed.
Each patient needs a treatment plan that is tailored to his specific needs and situation. Some of the common components of an eating disorder treatment include:
- Counseling or psychotherapy. This is the most important component of eating disorder treatment. Through therapy, the patient will learn to have a healthy relationship with food and develop new strategies for coping with the stress of everyday life. Continuing therapy is key to maintaining healthy eating habits and having a realistic and positive body image.
- Medication. Although no medication can cure an eating disorder, medications can be valuable in controlling urges and anxiety and treating coexisting conditions that may exacerbate or trigger the eating disorder.
- Medically supervised weight restoration. Patients with an eating disorder are often significantly underweight or overweight. This can cause dangerous and sometimes life-threatening damage to the body. The first goal of treatment is usually to get the patient to a healthy weight.
- Nutritional education. Nutritional counseling is paramount in the long-term management of an eating disorder. Those suffering from an eating disorder have an unhealthy relationship with food and need to learn or relearn how to plan a healthy diet.
- Support groups. Support groups are a valuable way to connect with people going through a similar struggle. Eating disorders sometimes need lifelong maintenance, and support groups can be key to staying in recovery.
How Much Will Eating Disorder Treatment Cost?
The cost of eating disorder treatment depends on a number of factors. Inpatient treatment can range anywhere from $500 to $2,000 a day, and the average cost for a 30-day stay in a treatment facility is $30,000. Patients often need from three to six months of inpatient care.
Outpatient care, including medical monitoring and continuing therapy, can reach upwards of $100,000. The cost of any patient’s treatment can vary widely from these figures, depending on the severity and duration of the eating disorder.
Be sure that you are clear on what your insurance will cover before deciding on any course of treatment.
You may have to make an expected out-of-pocket contribution even if your Aetna plan covers treatment. Be sure to check your specific plan to find information regarding copays and deductibles that you may be responsible for. For help finding treatment for an eating disorder, call us at today. We are available 24/7 to help you seek treatment.
Inpatient Eating Disorder Treatment vs. Outpatient Services
When you’re crafting your treatment plan, the general goal is to find the duration and intensity of services that are appropriate for your situation. Inpatient treatment involves a patient receiving 24-hour care in a residential facility.
This can be valuable in the treatment of an eating disorder because the patient will receive constant medical monitoring. The patient is provided therapy and medication in a very structured setting. This type of treatment is often used for severe eating disorders.
Inpatient treatment allows patients to avoid the stresses of everyday life and fully focus on their recovery.
Outpatient treatment is more flexible and may be attractive to those with responsibilities related to children, work or school. Therapy and medical attention are provided several times a week, with the patient going home in between sessions. These programs can vary in frequency and duration the patient’s needs.
When a patient with an eating disorder first seeks treatment, a stay in a hospital is sometimes needed. Eating disorders can cause dangerous and life-threatening damage to the body, including dehydration, electrolyte imbalances, kidney and cardiac damage, and irregular heart rhythms. These issue need to be resolved before any further progress on the eating disorder can be made.
Dual Diagnosis Eating Disorder Therapy
Eating disorders are often accompanied by one or more coexisting disorders.
Although it is sometimes difficult to determine whether the other disorders were causes or effects of the eating disorder, it is imperative that they be treated at the same time as the eating disorder.
An untreated mental disorder can be a huge obstacle to staying in recovery long-term. Some of the most common conditions seen alongside an eating disorder are as follows:
- Obsessive-compulsive disorder. OCD is an anxiety disorder that is characterized by feelings of anxiety that cause sufferers to have reoccurring and obsessive thoughts and drive them to perform repeated and compulsive actions. Many of those struggling with an eating disorder have such thoughts and actions related to food, so these conditions can be strongly linked.
- Other anxiety disorders. These can include generalized anxiety disorder, PTSD and social anxiety disorder. The patient may develop an eating disorder in an attempt to control the symptoms of any of these.
- Depression. Depression can stem from abnormal brain chemistry or an event in the patient’s life. The symptoms of depression can exacerbate or trigger the symptoms of an eating disorder.
- Substance abuse. When a patient is struggling with an eating disorder, he/she may turn to drug or alcohol use as a coping mechanism. It is imperative that these issues are dealt with during the course of treatment.
If you or a loved one is struggling with an eating disorder or any of the aforementioned issues, call us at . Our representatives are available 24/7 to help you get started on the road to a healthier life.
Insurance vs. Private Pay for Eating Disorder Options
When you are deciding on a course of treatment, it is important to have an idea of how much your insurance will cover and how much you are able to pay.
Some patients choose to privately pay for their treatment because of concerns about privacy or the desire to use an upscale facility that their insurance won’t cover. If you have the means to pay for treatment, you have many options.
Some facilities offer luxury accommodations, alternative treatments, longer stays and almost any amenity that you can think of.
If you don’t have the means to pay, you still have some financing options. Contact your treatment facility, as some facilities may offer programs that charge on a sliding scale income.
Other facilities may offer scholarships for needy families or financial aid to apply towards treatment. Many facilities offer payment plans that will spread the cost of treatment over a more manageable timeframe.
You may need to be persistent, but help in financing treatment is available.
A study has shown that about 80 percent of girls and women who receive care for eating disorder do not get the intensity of treatment that they need. They are sent home weeks earlier than recommended, which affects the time they stay in recovery. Make sure you are getting the care you need. An eating disorder can feel overwhelming, but help is available.
If you or a loved one would assistance in navigating your Aetna insurance policy and exploring treatment options, call us today at . It is not too late to turn your life around. Eating disorders that are addressed early have a much better outlook for successful treatment than those addressed later.
The unexpected costs of eating disorders
Struggling with an eating disorder can be a long and painful process — and an expensive one.
In an essay for the U.K. Independent this week, writer Sophie Jackson said she spent around 150 pounds, or about $200, per week on “binge foods” at the grocery store when she was suffering from bulimia.
“The endless cycle of buying food I knew I didn’t need or want, making myself ill, running money and doing it all over again felt something I would never escape,” she wrote. “The financial burden only heightened my stress.”
There are other costs associated with anorexia, bulimia and disordered eating, she wrote, including having to buy clothes of varying sizes (for those whose weight fluctuates wildly), diet teas and pills, laxatives, and gym memberships.
In fact, it’s common for people struggling with eating disorders to also have credit-card debt, said Melainie Rogers, the founder and CEO of Balance, an eating disorder treatment center in New York. “There tends to be an impulsivity that goes hand-in-hand with bulimia,” she said, which can lead to overspending.
Plus, people who are struggling may also have to miss days of work when they are not feeling well, she said.
Treatment costs up to $20,000 a month, or more
Treatment for an eating disorder can also be costly, Rogers said, especially for those whose insurance doesn’t cover treatment, or who don’t have insurance at all.
And those with insurance may have to battle the insurance company for expensive in-patient treatment.
And because insurance can be unpredictable, treatment facilities will sometimes ask for a deposit for a patient up front, which can be $10,000 to $20,000.
Can simulation stop medical errors, the third-leading cause of death?
The daytime program at Balance, which is 30 hours per week of treatment, costs between $17,000 and $20,000 per month. The intensive outpatient program there, for nine hours per week, costs between $7,000 and $10,000 for a six-week period. That’s typical for this type of treatment in a larger city, Rogers said.
Another reason treatment can be expensive: Many eating disorder patients with severe health problems will need 24-hour care at an inpatient facility, sometimes for up to three months, Rogers said. If insurance covers that treatment at all, it’s usually for a short period, up to 30 days.
Other insurance companies will suggest outpatient care first, to see if it works. If it doesn’t, the company will agree to pay for inpatient care, at facilities that employ medical doctors and psychiatrists full time.
Trying outpatient care first can be dangerous, Rogers said, because patients often have severe symptoms including risk of cardiac arrest and suicidal thoughts. “It’s saying to a cancer patient, ‘We’re going to give you half the dose for half the time and see if it has an impact,’” she said.
Some free resources
For those with eating disorders who can’t afford treatment, or don’t have insurance, there are some free resources available, Rogers said. Some hospitals, including New York Presbyterian, agree to treat patients for free when they participate in research studies, she said.
Other organizations, including one called Project Heal, offer scholarships to people who need treatment.
The National Eating Disorder Association also has a helpline, 800-931-2237, that people can call to find out what free resources are available in their area.
Still, finding the right treatment at a low cost can be difficult, Rogers said. Those with eating disorders are “an underserved population right now,” she said.
Financial troubles only compound the other underlying causes, Jackson wrote. “Until the reality of the financial stress of eating disorders is taken seriously, many will continue to suffer in silence, trapped by the very habits that once helped them to cope with serial poverty and stress.”
Eating Disorders: The Cost
If you’ve had any experience with eating disorder treatment, you’re probably aware that treatment is extremely expensive… and insurance coverage for specialized care is often limited.
Some treatment protocols extend for months – or even years.
There may be bills from multiple providers since treatment teams can involve a therapist, psychiatrist, dietician, and a medical doctor… Few specialized providers take insurance*.
Multiple appointments weekly, navigating from one session to the next, and in some cases, travel to far away programs for intensive care… Treatment can cost you… both in terms of time and money.
But sometimes, less is more. A few points to consider:
Gold Standard Treatments Are Time and Cost-Efficient
The vast majority of eating disorder cases can be safely treated in an outpatient setting with one-on-one therapy. According to the research, the most effective treatment for bulimia and binge eating is 20 weeks duration and consists of one-on-one sessions with a single provider [therapist].
For anorexia, a similar treatment applies over the course of 40-weeks. Involved, time intensive [expensive] programming or travel to far away residential programs are necessary in certain cases – in particular if there are acute medical concerns.
But most of the time, focused treatment in your home environment is the best course.
Extensive Programming Is Not Always Necessary
Depending on where you go for assessment, you will ly get dramatically different recommendations.
For example, in certain treatment settings, an individual with bulimia nervosa who is purging daily, might easily be referred to a Day Treatment program or Partial Hospital program – even if the individual is medically stable.
Many experts, however, would argue (as would the research) that the most effective and efficient treatment is 20-sessions of Enhanced CBT. You can only imagine the cost differential between these two distinct interventions. Forget about the time commitment and life disruption of going into a full Day Program.
Behavior Change – Early On
Eating disorder treatment should involve early change. Within the first 6-8 weeks of treatment, there should be significant shifts in food/weight-related behaviors. If not, then swiftly, treatment should be adjusted accordingly.
Many longer-term outpatient therapy interventions ( psychodynamic psychotherapy, “talk therapy”) can lead to emotional growth and healing over time but stabilizing an eating disorder needs to happen fast. Therefore, any issues that are not immediately impacting eating, should be put aside in the service of stabilizing eating and health.
I don’t mean to be crass, but focused, changed-oriented, faster moving treatment invariably will be easier on your wallet… among other significant advantages.
Alternative To Hospitalization for Kids and Teens
For adolescents and children, Family Based Treatment is the gold standard. It involves once weekly family meetings structured to support parents in helping their child restore weight. T is an alternative to hospitalization for acutely ill kids/teens. Inpatient or residential programs are $1500-2000 plus per day. T runs at fraction of the cost (about 10-15% of the cost to be exact).
The Bottom Line
So the bottom line is that it’s important to do your research…. to fully understand the specific treatment orientations used to treat eating disorders. Be sure you don’t sign on for more than you really need. Understand the time frame for the treatment before you start. Be sure that you understand the different levels of care and what options you have given your specific condition.
* Note: Columbus Park is in-network with Aetna and CHP (Consolidated Health Plans) insurance. In-network coverage means considerable less cost for treatment. Check with your plan to find out your co-pay and if you have any co-insurance or deductible.
If you don’t have Aetna or CHP but are insurance by a different carrier, you may be able to get coverage through an out-of-network benefit. We are hoping/planning to add work with more insurance carriers in the near future.
What Resources Are Available to Help Me Cover The Cost of Eating Disorder Treatment?
Contributor: Crystal Karges, MS, RDN, IBCLC, Director of Content and Social Media at Eating Disorder Hope/Addiction Hope
The cost of eating disorder treatment can be incredibly overwhelming, especially without adequate health coverage. Even with health insurance, many individuals may find that they are still needing to pay pocket in order to cover the cost of treatment needed for eating disorder recovery.
Whether treatment is sought at the residential level of care, outpatient care or anything in between, the price associated with treatment can cause may be needing individuals to question whether this is something they can realistically afford.
The Necessity of Professional Treatment
Because eating disorders are complex psychiatric illnesses, professional and comprehensive treatment is an absolute necessity for full recovery and healing. The consequences of eating disorders can be debilitating and potentially fatal, and prolonging the time before seeking out treatment will only increase severity.
Eating disorders in their most acute forms often require more intense forms of treatment and intervention, which is typically seen at the inpatient and/or residential phase.
The cost of treatment at this level can average around $80,000 for the length of stay, which is easily beyond the reach for many individuals who are needing this type of treatment.
How is it possible to reconcile the cost of treatment with the need for professional care with skyrocketing fees and lack of resources? Fortunately, there are resources available that are working to help support individuals financially in order to make treatment a possibility.
Organizations and Resources
Several organizations exist for the purpose of funding treatment for individuals with eating disorders. Check out the following resources and how these organizations are serving the eating disorder community:
- Project Heal: Project Heal is a non-profit organization that fundraises to provide grants to individuals who cannot otherwise afford eating disorder treatment. Project HEAL also works to raise awareness for eating disorders and promote recovery.
- The Kirsten Haglund Foundation: The mission of the Kirsten Haglund Foundation (KHF) is to provide hope, networking and financial aid to those seeking treatment and freedom from eating disorders.
- Manna Scholarship Fund: The Manna Fund is a non-profit organization dedicated to providing hope and financial assistance to individuals who need treatment for eating disorders.
- Moonshadow’s Spirit: In honor of the memory of Jennifer Mathiason, this organization offers need-based financial assistance to individuals with eating disorders.
If you or a loved one have an eating disorder and are unable to connect to professional treatment for financial reasons, please consider reaching out to one of the above-mentioned organizations. You are not alone in this journey and are deserving of the help you need for recovery!
About the Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating.
Combining clinical experience with a love of social media and writing, Crystal serves as the Special Projects Coordinator for Eating Disorder Hope/Addiction Hope, where her passion to help others find recovery and healing is integrated into each part of her work.
As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work with EDH/AH and nutrition private practice.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on September 13, 2016
Published on EatingDisorderHope.com
Cost analysis of inpatient treatment of anorexia nervosa in adolescents: hospital and caregiver perspectives
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The Dollars and Cents of Eating Disorders
I must admit that I cringe slightly every time I try to think about healthcare from an economics perspective. To me, this comes a little close to putting a dollar value on human beings, which feels uncomfortably post-humanistic to me. Nonetheless, there is no ignoring the ways in which economic concerns factor into policy decisions that drive our human services, including health care.
There are also a number of pragmatic reasons for thinking about the costs associated with illnesses; talking in dollars and cents can make for a convincing argument when seeking funding to do research on a particular illness, for example. The ability to reduce healthcare costs is incredibly compelling in a time of fiscal restraint.
Crow (2014) published a short article about the economic costs of eating disorder treatment. In this article, he highlights some recent studies that have examined factors related to “the economics of eating disorders” and suggests avenues for future research in this area.
I will preface my analysis by noting that healthcare economics are not my area of expertise, and I doubt that my university introductory micro- and macro-economics courses prepared me to present an in-depth deconstruction of healthcare costs for individuals vs. systems. I can, however, logic out some of the basics of “eating disorder economics” in a way that I hope will be thought-provoking, and I am open to discussion in the comments.
The conclusion that eating disorders cost a lot seems perhaps an obvious one. Ignoring, for now, the non-financial costs of eating disorders, anyone who has sought private treatment for eating disorders can tell you that it is not cheap.
Costs for individuals vs. costs for systems vary widely where you live and what kind of health care and insurance you have available.
One example that comes to mind when I think about the costs of treatment is a recent (and ongoing) Indiegogo campaign, where a mother sought to raise $60 000 to enable her daughter to seek intensive treatment for chronic anorexia.
Keep in mind that this is a Canadian example; some who has joked about “moving to Canada” for the “free health care” might be surprised to learn that “universal healthcare” does not mean that all services are covered, 100% of the time.
I was asked, when this campaign came out, whether this amount of money seemed standard for four months of treatment. Sadly, the only answer I could give was yes.
Though my own treatment was covered by the Ontario Health Insurance Plan, I was always aware that this treatment was not “free”; somebody is always paying, be it the government, the individual, or a third party insurance company.
Psychiatric care, dietician consultations, meal services, and other therapy all cost; often, they cost quite a bit.
This huge digression is all to say: it’s complicated. When you talk about money and health, you’re bound to stumble upon irreconcilable differences about who should be footing the bill. I will try to refrain from injecting too much opinion about this particularity, and move now to Crow’s article.
How much does eating disorder treatment really cost? As I alluded to above, I’ve found some to be a bit incredulous that 4 months of treatment could possibly cost $60 000. Crow introduces studies that have looked at this, primarily from a cost-effectiveness standpoint.
Cost-effectiveness analysis in some ways avoids the kind of “ick” factor I feel about monetizing people; instead, analysts compare different methods of delivering healthcare and look for a ratio of the costs to produce a gain in health over the health gains (e.g. years of life).
Ultimately, however, the studies Crow introduces look to determine what direct and indirect costs are involved in care for eating disorders. These studies might be helpful, for example, in determining whether one form of treatment is more cost-effective than another, resulting both in financial savings and more effective treatment.
In the context of a larger randomized controlled trial of individuals being treated for anorexia nervosa, Stuhldreher et al. (2012):
- Looked at direct (e.g. cost of hospitalization, etc.) and indirect (e.g. being absent from work, etc.) costs linked to eating disorders
- Found that costs totaled 5866 per patient per 3 months, and were mostly direct and related to hospitalization (approximately 3374 Euros)
Looking specifically at a randomized controlled trial of bulimia nervosa treatment, Crow et al. (2013):
- Compared cognitive behavioral therapy treatment (with or without Fluoxetine) and stepped care (from guided self-help, to Fluoxetine, to CBT) over 62 weeks
- Found that the cost for stepped care cost $12 146 (US dollars) per patient and CBT cost $20 317 per patient
Examining cost in a German health care setting, Haas et al. (2012) explored costs associated with hospitalization for AN and:
- Noted a mean cost of 4647 euros per patient
- Of this, 40% was allocated to nursing costs, 20% to overhead, 16% to therapist costs and 12% to physician costs
Wang et al. (2011) looked at a prevention program aiming to simultaneously reduce the incidence of disordered eating and obesity (Planet Health). They were interested in projecting the costs saved by preventing cases of bulimia.
To be honest, I am not sure how much I buy into a projection analysis of the impact of prevention programs- to me there are far too many other factors that could impact the long term impact of these programs, especially a program targeted toward girls 10-14.
Nonetheless, the authors are fairly conservative in their estimates, arguing that this program would ly prevent 1 case of BN, saving $33 999 and 0.7 years of life, adjusted for quality of life.
The Crow article reports on the article’s broader conclusion that a combined eating disorder and obesity prevention program would net $14 238 in savings and 4.8 years of life gained; I imagine that this thus reflects results for “obesity prevention.
” Again, I would be very cautious in using these results to support arguments for the long-term effectiveness of prevention initiatives.
Societal Perspective Analysis
Looking beyond dollars and cents, Crow notes that eating disorders may also have indirect costs lost time. Citing a study by Raenker et al. (2013) that focuses primarily on the parents and partners of individuals with eating disorders. Raenker and colleagues found that, in the month prior to hospital admission:
- Mothers spent an average of 90.6 hours providing care
- Fathers spent an average of 72 hours providing care
- Partners spent an average of 72 hours providing care
Though the Raenker et al. study has implications for indirect costs of eating disorders, the authors also focused on the type of support caregivers providers (primarily emotional) and received, and how this impacted their own feelings of distress.
Beyond the results of this particular study, it takes only a glance at the literature on quality of life and well-being for individuals with eating disorders and their loved ones to reveal compelling arguments for the non-financial costs of eating disorders.
Crow also discusses ongoing steps toward better understanding cost effectiveness and eating disorders. These include:
- A study by Goddard et al. (2013) about the Experienced Carers Helping Others (ECHO) study, a self-help intervention for day and in-patients with AN
- A study by Schmidt et al. (2013) about the MOSAIC study, wherein adults with AN are randomized to Maudsley model anorexia nervosa or Specialist Supportive Clinical Management
- A study by Bulik et al. (2013) comparing online vs. face-to-face CBT for BN
Overall, it would appear that researchers and policy makers are interested in learning more about the costs associated with eating disorders.
I am still reticent to assign dollar values to eating disorder cases and treatment; to me, the human costs are much more compelling.
I can’t begrudge this kind of work, however, because I do think that a fiscal argument tends to be compelling, especially to those who decide what funding goes where (primarily, the government…).
If these kinds of studies help to demonstrate the toll that eating disorders can take not only on individuals’ lives but on individual and national pocketbooks and thus direct more funding toward finding more effective solutions for eating disorders, I think they are well warranted.
What I would caution against, however, is reducing eating disorder “costs” to the financial. I do not believe that any of the studies Crow refers to, nor the Crow article itself, is doing this; I am worried about how these arguments could be taken up.
I would also be cautious in advocating for one form of treatment over another because it is more “cost-effective.” Just because a type of treatment is “cost-effective” for one (or many) people does not mean it will work for all.
Because I to be a broken record, I will reiterate: one size simply does not fit all, in eating disorder treatment.
So, readers, what do you think of taking an economics perspective on eating disorders? Do the figures surprise you, or are they in line with what you would expect?
Crow, S. (2014). The economics of eating disorder treatment. Current psychiatry reports, 16 (7) PMID: 24817201