With mental health being more prevalent and accepted in the contemporary world, you would think access to decent mental health providers would be readily available, but that’s not the case.
Many people who are on Medicaid are typically underrepresented or a part of minority communities. Those who are insured by Medicare and Medicaid have slim pickings and often have difficulty finding a therapist or psychiatrist that they can relate to or even simply like. The need for emotional health assistance is greater now than ever before in the U.S., and yet the government makes receiving this help extremely difficult.
The U.S. faces an unprecedented mental health crisis with rising rates of suicide and opioid deaths, and children’s mental health is declared a national emergency. A report from the Department of Health and Human Services Office of Inspector General found a dire shortage of mental health care providers for Medicare and Medicaid recipients. Only a small fraction of providers choose to accept federal or state insurance programs, and those who do see patients only see a handful at a time.
Providers don’t typically accept Medicare and Medicaid because of the low reimbursement rates and administrative burdens. Medicaid reimbursements for psychiatric services are much lower compared to the already devastating low payments that Medicare ever so graciously provides. In New Jersey alone, Medicaid only reimburses around 50% of the amount that Medicare does for the exact same psychiatric services.
On average, there are currently fewer than five active mental health care providers for every 1,000 enrollees in Medicare and Medicaid programs. Even though one in four individuals on Medicare and one in three individuals on Medicaid are living with a mental illness, less than half of each of those populations receive treatment or any type of assistance.
One-fifth of the people who utilize Medicaid have a substance use disorder, and much less than half of them seek out mental or physical assistance. Out of the small number of Medicaid- and Medicare-reliant people who receive mental health assistance, about one in four of them have to travel over an hour each way to receive treatment. Constant and multiple issues arise for these patients as the population far outweighs the number of providers readily available.
Not only is it nearly impossible for one utilizing government-based insurance to find a nearby therapist, but many of those who find help only see their providers once every two or three months. With the frustrating quest for mental health assistance being nearly impossible, accompanied by the scarce number of providers, long drives, limited transportation and other contributing factors, many simply give up trying to receive help or are discouraged from seeking it out from the start.
So what can we do to bridge the gaps between local mental health assistance and the vast population of people on Medicaid and Medicare programs? The Centers for Medicare & Medicaid Service (CMS) are being increasingly pressured to take action and improve these massive barriers by various individuals and advocacy groups writing complaint and statistical or research-based letters to the Department of Health and Human Services.
Some of the U.S. states have started to implement change, such as increasing payments for specific types of mental health providers and services, and several states edited the complex paperwork in hopes of making it easier to understand. However, we have much more work to do and much more land to cover.
Although CMS has started to implement change, these small reimbursement increases are just not enough to make a true difference. Medicare started to cover treatment programs circa 2020. They also started to cover mental health counselors during this time.
Medicaid needs to follow suit as there are greater numbers of individuals needing these programs and assistance compared to those on Medicare, although these changes are indeed a massive step in the right direction. Mental health needs to be a priority amongst every insurance provider, and doctors and therapists need to be paid what they’re worth. Equity needs to be distributed amongst all individuals, not just the ones who can afford it.
krosen@ramapo.edu
Featured photo courtesy of Centers for Medicare and Medicaid Services, Wikipedia
