HHS aims for mental health pay equity in new roadmap

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As efforts to improve access to mental health care and pay equity stall in Congress, the Biden administration and the Department of Health and Human Services have implemented a roadmap to increase access to behavioral health services, in addition to other health system improvements.

As part of the move toward access, the administration is proposing reforms to how behavioral health is funded, including through programs like Medicaid.

The Centers for Medicare and Medicaid Services, for example, have been ordered to allow Medicaid coverage and reimbursement for “interprofessional consultations.” For a longer-term strategy, CMS will test payment models “that leverage the integration of behavioral health to support holistic care delivery.”

Other elements of the roadmap include incentives for psychologists and social workers to integrate into primary care, with the CMS to create billing codes that take into account the monthly integration of care.

CMS will also change requirements for therapists and licensed mental health professionals, who currently only receive payment if they provide services under the supervision of the billing physician. In the agency’s proposed rule for physician fee schedules, reimbursement would be tied to more “broad” oversight, ostensibly increasing access.


Key to the roadmap is the idea of ​​integrated care. While integration often refers to the inclusion of behavioral health services in primary care settings, HHS said it approaches it more broadly, to also include the integration of physical health care in primary care settings. behavioral health facilities and the integration of behavioral health care with other specialty areas such as OB/GYN care. , as well as in social and other services.

What inspired the creation of the roadmap are sobering numbers. In 2020, more than 52 million Americans were affected by mental illness – about 21% of the adult population, according to government data. Substance use disorders affected 15% (37.9 million) of American adults, including 6.7% (17 million) of adults affected by both mental illness and substance use disorders. substance use.

This high prevalence of mental disorders and substance abuse in the United States was a major concern for policymakers even before the COVID-19 pandemic. The concern only grew. During the public health emergency, self-reported symptoms of anxiety increased, as did the rate of overdose deaths, Data broadcasts from the American Hospital Association.

The roadmap rests on a number of pillars: “Building system capacity” will develop “a diverse workforce ready to practice in integrated settings and invest in integrated care infrastructure”. The “Connecting Americans to Care” pillar will leverage health financing agreements, including efforts to realize the full potential of parity; and the “Supporting Americans by Creating Healthy Environments” pillar will invest in behavioral health promotion, upstream prevention, and recovery.


CMS, as part of its behavioral health strategy, is proposing to bundle certain chronic pain management and treatment services into new monthly payments; and proposes to cover opioid treatment and recovery services from mobile units, such as vans, to increase access for people who are homeless or live in rural areas.

Mental health issues continue to rise among Americans of all backgrounds, especially those who are black, young adults, over the age of 65, or who identify as LGBTQIA+, according to a recent CVS Health/Morning poll. Consult.

A majority of respondents, 59%, had concerns about their own mental health or that of their family and friends. That’s a 9% increase since April 2020. Another majority, 53%, agree that hearing about other people’s challenges makes them more comfortable seeking resources and taking care of themselves.

And since the start of the pandemic, most people agree that society has become more comfortable engaging in discussions about mental health (56%), using digital tools to improve mental health (58 %) and using telemedicine for therapy (63%).

A 2021 study showed that mental health services were the most common use of telehealth early in the pandemic. As depression rates soar, findings show more patients used telehealth for behavioral rather than physical issues.

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