Brain with gears Employers, health insurers and health care providers should focus on significantly increasing access to affordable and effective in-network specialty behavioral providers.

An extensive study of 21 million people with commercial health insurance shows that Americans with mental health conditions and substance use disorders in addition to physical health problems are outsized drivers of total health care costs, according to a new report.

Yet health care spending for mental health and substance use behavioral issues make up a small fraction of total health care spending, the report states.

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