Reducing Patient Cost for Outpatient Mental Health Services Helps Medicare Recipients Access Needed Care
By Shelby Crosier
About 1 in 5 adults in the U.S. are dealing with a mental health condition. This includes almost 14% of adults over 50. Only about half of those adults get treatment for their condition. The cost of mental health care, stigma, and provider availability often keeps people from seeking treatment.
Congress passed the Medicare Improvements for Patients and Providers Act in 2008, which lowered the percentage patients had to pay for outpatient mental health care. It also made that percentage equal to that for medical care. This approach is known as “parity.”
Researchers from Emory University’s Rollins School of Public Health explored the impact of Medicare parity in a new study, published in JAMA Network Open. They looked at survey data for Medicare beneficiaries with depression to see if more people accessed mental health services, and if they saw providers more often.
Lowering Mental Health Care Costs Increases Service Use
The researchers found that after Medicare parity, beneficiaries with depression using outpatient mental health services increased by over 6% every year. Their average use also increased by over half a visit per year.
Policies Work Together
The researchers also looked at the impact of the 2016 U.S. Preventive Services Task Force recommendation that all adults should be screened for depression during routine primary care. They found that the recommendation, together with reduced costs, increased service use by over 28%.
Why This Matters
These results show that lowering the cost of accessing mental health services encourages people with depression to seek care. Integrating screenings into routine care further promotes use by potentially reducing stigma and facilitating primary care referrals to mental health specialists.
“This work shows that policies which work on different parts of the system to reduce barriers seeking to mental health care can be highly effective and synergistic,” said Victoria Phillips, DPhil, associate professor of health policy and management.
More than 66 million Americans use Medicare for health coverage and nearly 27% of them have depression. Depression is a risk factor for developing other health conditions, like diabetes and heart disease, and worse health outcomes, including death. Improving access to mental health care for this group can greatly improve health for a large portion of the country.
“Policies that treat mental health care the same as medical care, through equal patient cost-sharing requirements and integrated routine care, can be powerful tools in helping people access needed care,” said Sonia Tetlow, PhD, the study’s first author. “They address both tangible barriers to mental health treatment, like cost and receiving a diagnosis, and intangible barriers such as the stigma often associated with mental health conditions.”
