Dive Brief:
- Hillary Clinton's campaign announced this week a comprehensive plan to fully integrate mental and physical healthcare system in an effort to end the current separations in access to care and quality of treatment.
- One of the cornerstones of the proposal is to enforce the mental health parity laws that already exist but "are too often ignored," the campaign said, citing a recent statistic by the National Alliance on Mental Illness that a patient seeking mental healthcare is twice as likely to be denied coverage by their private insurer than a patient seeking medical care.
- The proposal would also expand the reimbursement systems for collaborative care models in Medicare and Medicaid, which treat mental health and substance use conditions in primary care settings.
Dive Insight:
Clinton's sweeping proposal encompasses a broad approach toward achieving an integrated health system that also includes efforts toward early diagnosis and intervention; training law enforcement officers in crisis intervention; prioritizing treatment over jail for non-violent, low-level offenders; improving access to housing and jobs; and investing in brain and behavioral research.
From the payer perspective, the industry would see a multi-pronged approach toward enforcing mental health parity law that would include randomized audits of insurers and increased, transparent federal enforcement from the Department of Labor and HHS. The proposal says it further intends to enforce disclosure requirements on the medical management decisions used to deny behavioral healthcare, to allow federal agencies and patients to identify and prove parity violations.
The plan goes on to include tougher monitoring of mental health network adequacy, the creation of an easy process for patients, families and providers to report parity violations, and the publishing of complaint/response data.
Separately, Clinton's mental health plan would also encourage states to allow same-day billing, resolving a roadblock created in some state Medicaid programs by a prohibition on payments for mental health and primary care services provided to the same person on the same day, noting the practice adds obstacles and forces segmentation.