Takeaway 1: Severe OCD cases that require inpatient care signal opportunities for intervention

The severity of a patient’s symptoms often determines the care setting for OCD. Patients with mild or moderate symptoms are typically treated in outpatient settings, while those with severe symptoms are more likely to be treated in intensive health settings like inpatient care.⁷ People with OCD are often misdiagnosed, leading to incorrect treatment.²

Because severe OCD drives higher utilization rates, it accounts for a disproportionate share of costs. In the Optum Advisory study, among health plan members with OCD, less than 9% were severe, yet this cohort drove higher annual per-member costs than mild or moderate OCD across all care settings. Comorbid conditions amplified this impact: For example, OCD-related depression and eating disorders drove the highest average costs annually per member at $13,339 and $85,335, respectively.⁷ Importantly, treatment of OCD with ERP therapy significantly improves depressive symptoms.^6,8

These data suggest that health plans and health systems should prioritize helping patients with OCD get access to evidence-based ERP therapy. Effective outpatient treatment can help patients avoid the need for inpatient care — a dynamic that emphasizes the need for screening early, before symptoms worsen or become more resistant to treatment.⁶ Virtual ERP-based therapy could be key to getting those patients care quickly.⁷ For example, quick access to virtual ERP solutions like NOCD could prevent patients from progressing to severe OCD.⁶

Takeaway 2: Combining team-based care with proven virtual ERP therapy like NOCD can guide OCD patients to the right treatment at the right time

Multidisciplinary care teams often provide a stepped approach to OCD care, so patients receive care that matches their needs.⁹ Care teams also consider other important factors such as each patient’s comorbidities and response to prior treatments. Once a patient is screened and diagnosed, rapid access channels within clinical pathways allow care teams to quickly refer patients with OCD to evidence-based therapy for help managing symptoms before inpatient care becomes necessary.⁷

Integrating proven virtual ERP therapy like NOCD into team-based care pathways adds an accessible option for timely, targeted intervention. Because the therapy is delivered remotely, care teams can reach rural or underserved populations without the need for additional physical infrastructure.¹⁰

Takeaway 3: Preventing progression from moderate to severe OCD is integral to system strategy

OCD is a chronic condition, and symptoms can fluctuate throughout a patient’s life. Effective treatment and supportive environments can help alleviate symptoms, while stress and major life changes often make symptoms worse.¹¹

While patients with severe OCD drove the highest costs, more than 60% of health plan members in Optum Advisory’s study had moderate OCD.⁷

This finding underscores a critical opportunity: Intervention during earlier stage of OCD can significantly reduce clinical burden, utilization, and cost. First, better screening for OCD at the mild and moderate stages will help more patients get the treatment they need. Second, proven virtual ERP therapy methods like NOCD could be integral to that process, because they offer quick, accessible OCD treatment that can prevent patients from progressing to severe OCD.

Read the full Optum Advisory report

NOCD is setting the standard for how complex mental and behavioral health conditions are identified and managed, with the goal of ending the mental health crisis — starting with OCD and related conditions. As the world’s leading provider of OCD treatment, NOCD helps people reclaim their lives through specialized virtual therapy covered by insurance for over 138 million Americans. Members work with primarily full-time licensed therapists trained in OCD and Exposure and Response Prevention (ERP) therapy, the most effective and evidence-based approach for treating OCD, while also receiving ongoing support and progress tracking through the NOCD app. Founded in 2015 by CEO Stephen Smith, whose personal experience with OCD inspired him to create the company, NOCD is redefining how evidence-based mental health care is delivered — accessible, affordable, and effective for all.

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This report is sponsored by NOCD, an Advisory Board member organization. Representatives of NOCD helped select the topics and issues addressed. Advisory Board experts wrote the content, maintained final editorial approval, and conducted the underlying research independently and objectively. Advisory Board does not endorse any company, organization, product or brand mentioned herein.

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