On Thursday, January 11th, 2024, the National Academies of Sciences’ Committee on Strategies to Improve Access to Behavioral Health Care Services through Medicare and Medicaid hosted a virtual webinar on Innovations to Improve Mental Health and Substance Use Disorder Access in Medicare, Medicaid, and Marketplace Insurance Plans. This was the third webinar in their series.
The first panel was comprised of staff from three state mental and behavioral health regulatory agencies: Colorado, Arkansas and Oregon. The Colorado regulator spoke about innovations in the areas of mental health parity, rulemaking and rates and forms. Additionally, there was a focus on network adequacy which refers to the difficulty or ease with which the client accesses services. In Arkansas, there was an attempt to increase access to mental health and substance use treatment. Additionally, there were changes in provider credentialing requirements for enrollment, organized care models and service structures, and policy. Some examples of these innovations were, private mental health providers received the same compensation as agencies, primary care providers were permitted to hire and bill on behalf of clinicians. Similarly, the Oregon regulators focused on adequacy standards and credentialling. Hence, attempts were made to improve ease in enrollment, and the regulatory agency took responsibility for the provider credentialling certification as well as lifted some requirements.
The second panelists were representatives from Blue Cross/Blue Shields, Medicaid and Medicare. Blue Cross Blue Shields reported about engaging in innovations to increase clinician participation such as increasing reimbursement, and a focus on primary care provider model, community program and partnerships to increase access to mental health services, and public policy. However, there was the caveat that though increasing reimbursement was shown to be helpful, it did not solve the issue of shortage of clinicians. Medicaid innovations sought to increase provider participation, improve network adequacy and access standards and payment rate and reducing administrative burden through centralized processing of credentials and treatment planning. Finally, the focus of Medicare was improving access to quality care, equity and engagement and data analytics for action and impact.
By Aretha Campbell, Policy Intern