As budget conversations ramp up, most benefits leaders are facing the familiar pressures of reducing total spend, simplifying vendor relationships, and expanding access to care without sacrificing outcomes. At the same time, employers are seeing the sharpest cost increases in over a decade. According to Business Group on Health, employer-sponsored healthcare costs are projected to rise nearly 8% in 2025.
In that balancing act, it’s no surprise that substance use support can get overlooked. It’s often viewed as a behavioral health “extra” or ”nice-to-have”. But as teams are pushed to consider modern care models that can show both impact and financial return, substance use belongs higher on the list.
48.4 million people in the U.S. have a substance use disorder. Many go undiagnosed, and even fewer receive care. That risk often hides behind more familiar conditions like diabetes, heart disease, cancer, and depression. It shows up in ER visits, inpatient stays, pharmacy claims, and disability leaves, but it rarely gets flagged as the root cause.
It’s easy to miss unless you’re looking for it, and if you’re not addressing it directly, you’re paying for it elsewhere.
When substance use is addressed early and consistently, the impact is clear. A peer-reviewed, claims-based study of 7,586 participants found that providing digital substance use support led to a 33% drop in medical claims and more than $6,700 in annual savings per participant—delivering a 4.5 to 1 return on investment.
Savings were driven by fewer hospitalizations, lower ER use, and reduced inpatient and outpatient claims. As expected, the strongest outcomes came from members who engaged more deeply with care, saving $2,122 more than non-engaged members, a reminder that outcomes follow engagement.
That’s not something every behavioral health program can show. In fact, a recent analysis from the Peterson Health Technology Institute found that most virtual behavioral health platforms showed limited or no measurable return. And because these platforms charge PEPM regardless of engagement, they’re adding over $25 million in cost for every million members.
If you’re refining your 2026 budget and strategy, chances are you’re asking the same questions many teams are right now:
- Which programs are actually improving outcomes?
- What are we paying for, and can we tie it to impact?
- Where can we close care gaps?
- How do we support chronic conditions more effectively?
- Where can we consolidate without losing value?
Substance use care might not be the first place teams look, but it often supports the very goals they’re trying to solve for.
Done well, it reduces avoidable spend, improves outcomes for chronic conditions, fills access gaps, and connects people to care before costs spike. And it’s one of the few areas where engagement and outcomes can be measured, and priced, accordingly.
In a year when every line item is under review, substance use support deserves more than a passing mention. It’s a smart addition to the cost containment conversation, and a practical step toward better care.
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