Medicare Mental Health Parity: A High Potential Change that is Long Overdue
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Abstract
Recent changes in legislation regarding mental health parity in Medicare will revolutionize payment for mental health care and delivery systems. This commentary discusses why this policy change was essential to promote adequate care for populations served by Medicare and to address expected changes in beneficiary, provider, and plan behavior as more equitable payments by Medicare are implemented.
Keywords
Medicare mental health benefits parity health reform health care financingReferences
- 1.Medicare Improvements for Patients and Providers Act of 2008. 2008.Google Scholar
- 2.Kessler RC, Merikangas KR. The National Comorbidity Survey Replication (NCS-R): background and aims. International Journal of Methods in Psychiatric Research. 2004;13(2):60–68.CrossRefPubMedGoogle Scholar
- 3.Loftis C, Salinsky E. Medicare and Mental Health: The Fundamentals. Washington: George Washington University, National Health Policy Forum; 2006.Google Scholar
- 4.Substance Abuse and Mental Health Services Administration. Medicare, Medicaid, and Managed Care Analysis: A SAMHSA/Center for Mental Health Services Project. 2002.Google Scholar
- 5.Cowell AJ, Grabill TC, Foley EG, et al. Trends in number of persons with mental health and substance abuse disorders and payments for their services in public and private sector health plans. In: Manderscheid R, Berry J, eds. Mental Health, United States. Rockville: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services; 2004.Google Scholar
- 6.Medicare Mental Health Equity Coalition. Letter to Chairman Dingell and Ranking Member Barton from Medicare Mental Health Equity Coalition. To: Honorable John Dingell and Honorable Joe Barton, Committee on Energy and Commerce; 2007.Google Scholar
- 7.Trivedi AN, Swaminathan S, Mor V. Insurance parity and the use of outpatient mental health care following a psychiatric hospitalization. Journal of the American Medical Association. 2008;300(24):2879–2885.CrossRefPubMedGoogle Scholar
- 8.Testimony of Dr. Ron Manderscheid. Washington: Committee on Ways and Means, Subcommittee on Health; 2007. [Presentation slides can be made available by the authors].Google Scholar
- 9.Congressional Budget Office. Cost Estimate: H.R. 6331 Medicare Improvements for Patients and Providers Act of 2008. Washington: Congressional Budget Office; 2008.Google Scholar
- 10.Mumford E, Schlesinger H, Glass G, et al. A new look at evidence about reduced cost of medical utilization following mental health treatment. Journal of Psychotherapy Practice and Research. 1998;7(1):68–86.Google Scholar
- 11.Sturm R. The myth of medical cost offset. Psychiatric Services. 2001;52(6):738–740.CrossRefPubMedGoogle Scholar
- 12.Ringel J, Sturm R. Financial burden and out-of-pocket expenditures for mental health across different socioeconomic groups: results from HealthCare for Communities. Journal of Mental Health Policy and Economics. 2001;4(3):141–150.PubMedGoogle Scholar
- 13.Slade EP, Salkever DS, Rosenheck R, et al. Cost-sharing requirements and access to mental health care among Medicare enrollees with schizophrenia. Psychiatric Services. 2005;56(8):960–966.CrossRefPubMedGoogle Scholar
- 14.Daly R. Congress ends Medicare’s mental health copay bias. Psychiatric News. 2008;1:1–2.Google Scholar
- 15.Kirschstein R. Insurance Parity for Mental Health: Cost, Access, and Quality. Bethesda: National Institute of Mental Health; 2000.Google Scholar
- 16.Goldman HH, Frank RG, Burnam A, et al. Behavioral health insurance parity for Federal employees. New England Journal of Medicine. 2006;354(13):1378–1386.CrossRefPubMedGoogle Scholar
- 17.Office of the Inspector General. Medicare Part B Payments for Outpatient Mental Health Services. Rockville: Office of Inspector General, U.S. Department of Health and Human Services; 2001.Google Scholar
- 18.Glied S, Frank R. Shuffling toward parity-bringing mental health care under the umbrella. New England Journal of Medicine. 2008;359(2):113–115.CrossRefPubMedGoogle Scholar
- 19.Mechanic D. Removing barriers to care among persons with psychiatric symptoms. Health Affairs. 2002;21(3):137–147.CrossRefPubMedGoogle Scholar
- 20.Wang PS, Lane M, Olfson M, et al. The primary care of mental disorders in the United States. In: Manderscheid R, Berry J, eds. Mental Health, United States. Rockville: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services; 2004.Google Scholar
- 21.Bazelon Center for Mental Health Law. Medical Homes and Integration of Mental Health: A Healthcare Reform Issue Brief. Washington: Judge David L. Bazelon Center for Mental Health Law; 2008.Google Scholar
- 22.Colton C, Manderscheid R. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Preventing Chronic Disease. 2006;3(2):A42.PubMedGoogle Scholar
- 23.Institute of Medicine. Crossing the quality chasm: A new health system for the 21st century. Washington: National Academy Press; 2001.Google Scholar
- 24.Petterson SM, Phillips Jr RL, Bazemore AW, et al. Why there must be room for mental health in the medical home. American Family Physician. 2008;77(6):757.PubMedGoogle Scholar
- 25.National Council for Community Behavioral Healthcare. Medical Homes and People with Mental Illness: A National Council Issue Brief. 2008. Available at: http://www.thenationalcouncil.org/cs/public_policy/medical_homes_issue_brief. Accessed November 25, 2008
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