What Does the Biden Mental Health Plan Mean for Providers?
Mental health providers who heard President Biden’s State of the Union speech a couple of weeks ago may have noted an interesting section. The president announced a formal national strategy to combat the mental health crisis. We hope Biden’s mental health plan will truly be a significant step forward in addressing the burdens faced by patients and providers.
Doug Fir Billing actively and passionately supports mental health care for all. And we celebrate all the providers who are working so hard to make a difference. As a medical biller for therapists and other behavioral practitioners, we’re honored to do our part to support you. Connect with us to learn more about how our services can help.
A Surge in the Need for Services
The United States had a slowly-simmering mental health crisis before the pandemic. Once COVID-19 arrived, with everything it brought our way, the crisis boiled over in a dramatic fashion. Isolation, fear, and overwhelming loss hit us swiftly. And an already-burdened system had no room to give.
Millions of people who tried to access mental health services couldn’t get them when needed, if at all. These stats from 2020 give a glimpse into the turmoil:
More than 17 million adults faced delayed or canceled appointments.
More than 7 million adults had to deal with delays in getting prescriptions.
Almost 5 million adults couldn't get the care they needed at all.
Mental wellness for children and adolescents has been equally stark in the past two years. Schools, parents, and counselors are all seeing the evidence of an emotionally overwhelmed population. These rising needs make Biden’s plan all the more necessary and welcome.
Key Points of the Biden Mental Health Plan
In recent years, US society has become more open to discussing mental health, but the systems to treat it haven’t kept up. This mental health agenda could represent a positive step toward adequately managing the nation’s mental health crisis.
While many details and logistics are not yet clear, some critical pieces to the plan offer hope for the nation's mental well-being. Here are a few of the key parts of the agenda for providers to understand.
Parity in Care
The federal Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 was supposed to help close the gap between insurance coverage for physical medical care and mental health care. That is, it requires insurance companies to provide the same level of coverage and co-pays for mental health and addiction disorders as they do for medical care.
On paper, that law sounds reasonable and helpful. In reality, the federal government did little to enforce it. States mostly have been able to ignore it, leaving an enormous disparity instead. We know this by looking at the stats of people who seek out-of-network services.
If there were true parity, OON percentages would be roughly the same between medical and mental health care. However, people go out of network about 85% more for mental health services than they do for physical care. Clearly, the barriers to mental health care are more significant than they are to medical services.
The president’s plan promises to strengthen the parity law at the federal level. Some of the components he plans to include are:
Boosting immediate, same-day access to mental health care for veterans
Expand access to virtual mental health services
Increase mental health care access in schools, universities, and colleges
Simplify the processes and methods for finding mental health providers
Adequacy of Network
Biden’s call to build an “adequate network of providers” could be game-changing. This significant piece of his agenda may be the most crucial.
The administration acknowledges that a critical shortage of mental health providers is at the core of our crisis. He plans to address the shortage by requiring insurance companies to have enough therapists and counselors to meet the needs of their members.
The “how” of filling the gaps and having a sufficient network is where policy will come in. Here are a few key pieces of the planned budget:
$700 million for programs to attract behavioral and mental health specialists
$225 million for programs that recruit and train paraprofessionals, such as community health workers
$135 million for outreach and training to prevent burnout, depression, and suicide among mental health workers
A focus on recruiting more culturally-diverse providers to serve in our communities
One significant reason for our current inadequate network is that many insurance companies do not pay their mental health providers enough for the most part. It’s difficult to recruit a therapist or psychologist when you only pay them about $75 an hour. Of course, rates vary, but the reality is that providers frequently do not receive adequate compensation for their expertise and time. Not even close.
Under the Biden mental health plan, insurance companies will have to recruit and retain more practitioners, in theory. And that means they will have to pay them more.
If this situation really comes about, it should also help increase parity between medical and mental health care. Patients often have to go out of network to get services because there aren’t enough providers in-network. Addressing the inadequacy of providers at the insurance policy level should alleviate that problem.
What Does It All Mean for Providers?
We know that every administration makes promises and has grand plans. And we know that it’s rare for all the promises to be fulfilled. We also recognize that Biden’s proposal has a lot of gaps, especially when it comes to substantive policy change aimed at insurance providers.
But let’s imagine a perfect world where everything in the Biden mental health plan comes to fruition. (Sounds lovely, right?) In that dream scenario, here are some things that mental health practitioners might see:
An increase in contracted rates from insurance companies
An increase in recruiting, especially for communities of color
An increase in access to mental health care for you and your staff
Possible school loan repayment options
A more sustainable caseload as paraprofessionals are able to support some patients
Doug Fir Is Here for You
Whether this plan does or does not change things, Doug Fir Billing is here to support you and your practice. We handle all of your billing so that you can focus on patients. Reach out today to learn more.
