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Really excellent blog identifying some of the many challenges providers and patients face in the mental health telehealth field.
ReplyDeleteAs I was researching my response to your blog, I came across a few articles discussing how parity – or ability to pay for mental health services. This has been greatly impacted by state and federal laws. The ACA at the federal level promotes telehealth services.
In 1996 the United States passed the Mental Health Parity Act mandated private and public health insurers to pay for mental health services at similar rates as medical conditions. (USHHS, 2008) “ MHPAEA supplements prior provisions under the Mental Health Parity Act of 1996 (MHPA), which required parity with respect to aggregate lifetime and annual dollar limits for mental health benefits.” (USDOL, 2008)
“The Mental Health Parity Act, and its successor, the Mental Health Parity and Addiction Equity Act (MHPAEA) The Mental Health Parity Act, and its successor, the Mental Health Parity and Addiction Equity Act (MHPAEA) are the result of decades of shifting opinion in how we view the seriousness of psychological disorders and mental health. The MHPAEA requires – for certain qualified insurance plans – mental health/substance abuse coverage be at parity with medical/surgical coverage. (Yang, 2016)
I have seen a nearly exponential increase of patients seeking mental health services ED setting in the past 10 years. The use of telehealth medicine to provide these services to rural and less accessible areas is important.
” The number of telemental health visits grew on average 45.1 percent annually, and by 2014 there were 5.3 and 11.8 telemental health visits per 100 rural beneficiaries with any mental illness or serious mental illness, respectively. There was notable variation across states: In 2014 nine had more than twenty-five visits per 100 beneficiaries with serious mental illness, while four states and the District of Columbia had none.” (Mehrotral, et al., 2017)
My post is a bit lengthy but the information is germane to the overall post content. Basically, due to differences in state and federal legislation, patients with mental illness may receive different levels of care based on where they live. Telemedicine/telehealth would be ideal for these patients, but legislation has been problematic.
As you mentioned, this patient population has enough compliance issues related to their plan of care due to their illness. The last thing they need is to add additional stressors of varying levels of benefits depending on their area of residence.
Your blog is excellent. Thanks for sharing such valuable information - Deb Toth
References:
Mehrotral, A., Huskamp, H. A., Souza, J., Uscher-Pines, L., Rose, S., Landon, B. E., . . . Busch, A. B. (2017, May). Rapid Growth In Mental Health Telemedicine Use Among Rural Medicare Beneficiaries, Wide Variation Across States. Health Affairs, 36(5), 909-917. doi: 10.1377/hlthaff.2016.1461
USDOL. (2008). Mental Health and Substance Use Disorder Parity. Retrieved from USDOL.gov: https://www.dol.gov/ebsa/mentalhealthparity/
USHHS. (2008, October 7). Mental Health Parity Act of 1996. Retrieved from US Department of Health and Human Services : https://www.shrm.org/resourcesandtools/legal-and-compliance/employment-law/pages/mentalhealthparityactof1996.aspx
Yang, T. (2016, August 15). Health Policy Brief. Retrieved from Health Affairs: http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_162.pdf
Well it's actually 7:40 pm in Ohio on 8/24/17 - so not sure what's with the time being off on my post - could be settings? not sure - thanks Deb Toth
ReplyDeleteI can understand how providing service to psychiatric patients can be challenging. It is disheartening to see patients struggle and end up with emergency situations, hospitalized, incarcerated, and suicidal for conditions that are treatable. You make an excellent point about treatment compliance and how technology can support and improve patient health outcomes. Staying compliant would certainly control and reduce symptoms, decrease relapse and hospitalization, and improve overall physical, mental, emotional, and social function of psychiatric patients. The use of telehealth to improve patient health outcomes and enable patients to live a more meaningful life is a solution that would positively transform treatment and compliance in mental health. Excellent information.
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