A Kaiser Family Foundation survey found that all responding programs had at least one initiative to expand behavioral health services.
The difficulty of accessing behavioral healthcare is not new, but the COVID-19 pandemic has further aggravated the imbalance between need and access. The pandemic has resulted in more people suffering from mental health conditions such as anxiety and depressive disorders (or a combination of both). In 2019, 11% of adults tested positive for symptoms of anxiety or depression.
In April and May 2020, during the first months of the pandemic, this proportion tripled to around 33%, according to data from the US Census Bureau. Barriers to access include the ability to reach and travel to suppliers; supplier availability; social factors, such as a reluctance to seek help; and, above all, the cast.
Access to services is especially important for Medicaid enrollees, who have also experienced increased levels of behavioral health problems during the pandemic, according to a Kaiser Family Foundation (KFF) report on Medicaid’s expansion of services. behavioral health. The foundation’s annual budget survey of state Medicaid officials showed that all states responding to the survey reported having implemented at least one behavioral health initiative to expand access over the past few years. two years, in particular by offering a crisis service and developing telehealth. “You really see it so clearly that every state we surveyed reported at least one initiative to expand behavioral health care initiatives,” says Madeline Guth, policy analyst at KFF and author of the Medicaid Behavioral Health Report.
This is not the first time the government has stepped in and tried to improve access to mental health services. The Mental Health Parity and Drug Equity Act of 2008 prohibited payers from making mental health coverage more restrictive than physical health coverage, although there are still many parity gaps. A 1996 law of the same name ensured that large group health plans could not impose less favorable lifetime or annual mental health benefit limits compared to medical/surgical benefits. The Affordable Care Act required all health plans to classify mental health and addictions services as essential health benefits.
Medicaid coverage is a critical part of behavioral health coverage in the United States because the programs cover a disproportionate share of people with behavioral health issues. As of July 1, 2021, Medicaid programs in 44 states and the District of Columbia covered telehealth services for mental health issues, including audio-only services, according to Guth’s report. In the past, behavioral health services have often been excluded from Medicaid managed care contracts, which in some cases has undermined parity. Guth’s report shows that about three-quarters of the 41 states that have Medicaid managed care programs have cut behavioral health services.
New government initiatives also address access to behavioral health. The American Rescue Plan Act provided expanded Medicaid funding to some behavioral health care providers and crisis centers, and the Build Back Better Act, if enacted, would provide additional funding for community mental health services.
Integrating care is one way to provide better access. Nearly half of the states in the KFF survey reported integrated service initiatives, whether allowing same-day payment for medical and behavioral health services or providing these services in one location. notes Guth.
Deborah Abrams Kaplan writes on medical and practice management topics.