RTI Study Shows Pervasive Disparities in Access to In-Network Behavioral Healthcare
A report this week from not-for-profit research institute RTI International adds to mounting research showing a lack of access to affordable mental health and substance use disorder treatment in the United States continues.
NABH helped sponsor the study,
Behavioral Health Parity—Pervasive Disparities in Access to In-Network Care Continue, which found that patients went out-of-network 3.5 times more often to see a behavioral health clinician than a medical/surgical clinician, 8.9 times more often to see a psychiatrist, 10.6 times more often to see a psychologist, 6.2 times more often for acute behavioral inpatient care, and 19.9 times more often for sub-acute behavioral inpatient care.
“It’s upsetting, though not surprising, that RTI researchers found what we’ve seen for too long: patients who need critical behavioral healthcare services are forced to seek that care out-of-network much more than they do for medical-surgical services because of inadequate insurer networks. This comes at higher personal costs to these patients,” NABH President and CEO Shawn Coughlin said in a statement. “Worsening the problem, behavioral healthcare providers are reimbursed at much lower rates than their peers in medical/surgical facilities.
The Mental Health Parity and Addiction Equity Act passed more than 15 years ago,” he continued. “It’s time lawmakers and regulators ensure this critical law is implemented fairly and fully nationwide.”
The study also found that in-network office visit reimbursement, which health plans use to encourage provider in-network participation, was higher for medical/surgical clinicians than office visits with behavioral clinicians: 22% higher on average; 48% higher at the 75th percentile; and 70% higher at the 95th percentile. Notably, physician assistants were reimbursed for office visits at an average amount 19% higher than psychiatrists and 23% higher than psychologists.
In Case You Missed It: Watch Our Foundation’s Talent-Recruitment, Part II Webinar
The
NABH Education and Research Foundation hosted the second in its two-part webinar series about talent recruitment and retention on Thursday, April 18.
NABH Board Chair Frank Ghinassi, Ph.D., A.B.P.P., president and CEO of Rutgers University Behavioral Health Care, and senior vice president of the Behavioral Health and Addictions Service Line at RWJBarnabas Health, co-led the webinar with workforce consultants
Beth Kuhn of Stonegate Strategies and
John Pallasch of One Workforce Solutions.
The presenters discussed long-term solutions to recruiting and retaining talent through partnerships; how skills-based hiring is a more effective approach to talent management; and what funding sources are available to help NABH members in their workforce-related efforts.
If you missed it, please click
here for the webinar’s recording,
here for the presentation slides, and
here for the poll question results.
And be sure to join us for our Annual Meeting Workforce Panel on
Monday, May 13 from
4 – 5 p.m. ET in the Salamander Washington DC’s Grand Ballroom. NABH Education and Research Foundation Vice President Jim Shaheen, CEO of New Season, will moderate the panel, which will include this week’s webinar presenters Kuhn and Pallasch, as well Jason Brooks, senior vice president of Human Resources at New Season, and Rhonda Ashley-Dixon, vice president of strategic partnership and engagement at Vanderbilt Behavioral Health.
Please Meet Our Exhibitors and Sponsors at the 2024 NABH Annual Meeting Next Month!
NABH appreciates the generous support of our exhibitors and sponsors, whose valuable products and services help NABH members deliver quality behavioral healthcare every day to those who need it.
Please make time to visit our exhibitors and sponsors at the Annual Meeting from May 13-15 at the Salamander Washington, DC. Before then, you can view a
list of our exhibitors and sponsors on our Annual Meeting homepage.
Also, please
register for the Annual Meeting,
reserve your hotel room, and
view our preliminary program, if you haven’t done so yet.
We look forward to seeing you in Washington!
FTC Brings Case Against Monument to Enforce Health Data Privacy Protections
The Federal Trade Commission for the first time took enforcement action through the
Opioid Addiction Recovery Fraud Prevention Act (OARFPA) to stop telehealth company Monument from disclosing health data to advertising platforms by bringing a case against the company, which treats patients with alcohol addiction virtually,
Inside Health Policy reports
.
The story also noted that Monument’s data-sharing practices also violated section 5 of the
FTC Act, resulting in a proposed ban on data sharing with third parties and a $2.5 million civil penalty, FTC says.
Enacted in 2018, OARFPA authorizes FTC to seek civil penalties for unfair or deceptive acts or practices related to substance use disorder treatment services or products.
Center for Health Strategies Examines Medicaid Options to Cover Incarcerated Youth
The Center for Health Care Strategies, together with the Annie E. Casey Foundation, has developed a policy cheat
sheet outlining requirements that will expand Medicaid options to cover services for incarcerated youth starting in 2025.
Several provisions under the
Consolidated Appropriations Act of 2023 will expand Medicaid services to youth who are incarcerated, of which nearly two-thirds have a diagnosable mental health or substance use disorder, according to the Medicaid Payment and CHIP Access Commission, or MACPAC.
The fact sheet outlines the new requirements, opportunities for Medicaid to collaborate with the corrections sector, and next step for Medicaid agencies before the provisions take effect.
Reminder: The National Academies to Explore Mental Health Services for Anxiety & Mood Disorders in Women
The National Academies
Forum on Mental Health and Substance Use Disorder will host a hybrid public
workshop in Washington, D.C. and via webcast to explore mental health care services related to anxiety and mood disorders in women on April 29 and 30.
Sponsored by the Health Resources and Services Administration, the workshop will examine currently available evidence to identify, define, and prepare strategies for the provision of essential healthcare services related to anxiety and mood disorders in women across the life course.
Presentations will also describe health disparities, healthcare finances, and policies related to the quality and access of mental healthcare services available for women.
Reminder: Please Submit Data to NABH’s Denial-of-Care Portal
NABH thanks all members who have submitted data to the association’s
Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.
With guidance from our members, NABH has improved the portal by adding two elements:
- Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.
- The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.
We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs
Emily Wilkins.
Fact of the Week
Among U.S. college athletes, suicide is now the second leading cause of death after accidents—and rates have doubled to 15.3% from 7.6% in the past 20 years, according to a study published in the
British Journal of Sports Medicine. CNN analyzed the report’s findings in a recent
article.
For questions or comments about this CEO Update, please contact Jessica Zigmond.