Medicare Mental Health Parity: A High Potential Change that is Long Overdue

  • Laysha OstrowEmail author
  • Ronald Manderscheid


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.


Medicare mental health benefits parity health reform health care financing 


  1. 1.
    Medicare Improvements for Patients and Providers Act of 2008. 2008.Google Scholar
  2. 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. 3.
    Loftis C, Salinsky E. Medicare and Mental Health: The Fundamentals. Washington: George Washington University, National Health Policy Forum; 2006.Google Scholar
  4. 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. 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. 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. 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. 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. 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. 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. 11.
    Sturm R. The myth of medical cost offset. Psychiatric Services. 2001;52(6):738–740.CrossRefPubMedGoogle Scholar
  12. 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. 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. 14.
    Daly R. Congress ends Medicare’s mental health copay bias. Psychiatric News. 2008;1:1–2.Google Scholar
  15. 15.
    Kirschstein R. Insurance Parity for Mental Health: Cost, Access, and Quality. Bethesda: National Institute of Mental Health; 2000.Google Scholar
  16. 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. 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. 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. 19.
    Mechanic D. Removing barriers to care among persons with psychiatric symptoms. Health Affairs. 2002;21(3):137–147.CrossRefPubMedGoogle Scholar
  20. 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. 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. 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. 23.
    Institute of Medicine. Crossing the quality chasm: A new health system for the 21st century. Washington: National Academy Press; 2001.Google Scholar
  24. 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. 25.
    National Council for Community Behavioral Healthcare. Medical Homes and People with Mental Illness: A National Council Issue Brief. 2008. Available at: Accessed November 25, 2008

Copyright information

© National Council for Community Behavioral Healthcare 2009

Authors and Affiliations

  1. 1.Human Services Research InstituteCambridgeUSA
  2. 2.Mental Health and Substance Abuse ProgramsGlobal Health Sector, SRA InternationalRockvilleUSA
  3. 3.Department of Mental Health, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreUSA

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