Healthcare leaders committed to behavioral health “best practices” during an HHS roundtable event on Wednesday, while a key law on insurance coverage for mental health remains in limbo.
Insurers, medical societies, and other health industry leaders pledged to “advance evidence-based, high-quality, patient-centered care for individuals experiencing mental health conditions and the chronic disease of addiction.” Specific best practices include timely access to treatment and evidence-based and patient-centered care, according to the HHS press release.
These commitments arrive at a time when the existing Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is being walked back by the Trump administration.
MHPAEA requires insurers and health plans to provide coverage for mental health and substance use disorders comparable to how they cover other kinds of medical care. A federal rule during the Biden era further strengthened the standards for demonstrating such parity in coverage. However, a legal challenge ensued, with the Trump administration indicating that it does not intend to enforce MHPAEA while it is being reviewed.
Now, enforcement varies by state, Scott Falkowitz, DO, medical director for Northwell’s school mental health program and a child and adolescent psychiatrist at Cohen Children’s Medical Center in Glen Oaks, New York, noted in a recent interview with MedPage Today.
Unsurprisingly, payment and access were two major topics during Wednesday’s roundtable discussion.
Taft Parsons III, MD, chief psychiatric officer at CVS Health/Aetna, remarked on the uptick in requests for behavioral health services during and after the pandemic. The insurance giant has made efforts to improve access by getting more providers into its networks, introducing telebehavioral healthcare, and reaching more rural settings, he noted.
“But as we’ve improved access to care, to the number of providers … we then started to ask the question, ‘What are we getting folks access to?'” Parsons said. “There’s a good body of research to say what good care looks like, but we don’t necessarily have the tools within the system to always measure that and demonstrate that.”
Though a key U.S. government report on mental health, substance use, and addiction recently showed continued improvements in several metrics, especially among young people, experts who spoke at Wednesday’s meeting acknowledged there is still more work to be done.
“We are still kind of in our infancy in behavioral health,” Parsons said.
Arthur Evans Jr., PhD, CEO of the American Psychological Association, urged looking beyond metrics of care quality. “One thing that I know is that if we really want to change the system, we have to have payment models that get us what we want,” Evans said. “And so, if we want different outcomes, we’re going to have to align our payment systems around the outcomes that we want.”
“That means not just looking at those kinds of metrics, but really looking at how do we set up systems so that providers are being paid for the entire course of treatment. We believe very strongly that we ought to be looking at accountable care organizations and other payment models that really focus on all of the needs that people have,” he stressed.
Additionally, Charles Ingoglia, MSW, president and CEO of the National Council for Mental Wellbeing, discussed the promise of a transdiagnostic approach, or “not being fixated on a particular diagnosis, but really focusing on what are presenting problems and how do we help people return to their highest level of functioning as quickly as possible.”
“We have something to learn from the rest of the world in terms of task sharing,” Ingoglia added. “How do we expand the universe of people who can do evidence-based psychosocial interventions beyond clinicians to take some of the pressure off of the shortage of clinical personnel that we have?”
Kennedy closed out Wednesday’s meeting by reiterating the importance of evidence-based standards of care across mental health and substance use treatment.
“Strengthening our behavioral health system is a key part of the MAHA movement, which promotes healthy lifestyles through prevention-first, outcome-focused, whole-person care,” CMS Administrator Mehmet Oz, MD, said in a statement. “By committing to these principles, the healthcare leaders who signed today’s pledge have taken a significant step toward tackling the twin crises of addiction and mental illness that inflict untold suffering on millions of Americans and their families.”
