Are You Paying More for Mental Health Coverage? You’re Not Alone

Disparities between physical and mental health in-network and provider reimbursement rates are making it harder for American families to find affordable and available mental health treatment, putting lives at risk every day. While strides have been made to ensure that individuals with mood disorders have the insurance coverage they need through a combination of state and federal policy actions, The Milliman Report released this month, “Addiction and Mental Health vs. Physical Health: Widening disparities in network use and provider reimbursement”, shows that in-network mental healthcare is much harder to find, forcing employees and their family members to either pay significantly more for out-of-network care, or—even worse—go without care entirely. This data highlights that mandating comparable out-of-pocket costs for physical and mental health services does nothing to equalize payment between these different types of services if one is unable to make an appointment with an in-network psychiatrist.

Improved access to behavioral healthcare services could reduce overall healthcare spending because spending on physical healthcare is approximately 2-3 times higher for patients with any ongoing mental health diagnosis. Think about it, if you had to pay more out-of-pocket by visiting an out-of-network provider every time you needed a colonoscopy, annual mammogram or blood work, you wouldn’t do it as often, if at all.

One of DBSA’s key policy priorities has been to ensure parity in health insurance coverage for mental health services. Given this new data DBSA is calling on Congress to hold hearings to address these issues and enact new laws to enhance enforcement of the existing laws and improve the ability to appeal unfair insurance coverage practices.

More information about DBSA’s action on mental health parity is found here.

Please forward to colleagues, family, and friends to assist us in this grassroots effort to make our voice heard.

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How Do Peers Prioritize Treatment Outcomes?

Last summer DBSA conducted focus groups to understand how peers prioritize treatment outcomes. This project built on last year’s Supporting Wellness survey that had over 6,400 responses as well as the Voice of the Patient Report from the November 2018 externally-led Patient Focused Drug Development meeting. Results from the focus groups served as a foundation for a November 2019 workshop with peers and stakeholders in medical product development including staff from the FDA and National Institute of Mental Health. Output from the survey and the recent workshop will be used to inform a better understanding of significant treatment gaps and how to develop better medical products to treat mood disorders.

During the focus groups, a trained moderator from the Institute for Patient- and Family-Centered Care (IPFCC) asked questions and facilitated discussion among a small group of peers. To ensure response from a diverse population were captured, DBSA held rural and urban groups across different regions of the country. Because mental health looks different across cultures, we reserved half of the groups to hear from peers who identify as member of specific minority groups. Participants received an honorarium as thanks for participation. A paper detailing the results of the Supporting Wellness survey and the focus groups will be available in 2020. Access to the paper will be provided in a future Making Mental Health Matter newsletter.

DBSA offers peer-based, wellness-oriented support and empowering tools, programs and resources for peers and their supporters. We will be providing more opportunities for peers to share their perspectives with policy makers, clinical trial designers, and providers. Stay tuned for more opportunities to share your experience.

Please forward to colleagues, family, and friends to assist us in this grassroots effort to make our voice heard.

To continue to receive communications about issues that support access to quality mental health care,

Join Our Movement