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Medicare parity: we're not done yet!

Linda Rosenberg¹

¹MSIU, National Council for Community Behavioral Healthcare, Washington, DC, USA. MeenaD@thenationalcouncil.org

The Journal of Behavioral Health Services & Research

|May 19, 2010

Summary

Medicare is eliminating discriminatory copayments but must expand mental health coverage. True parity requires recognizing services like case management and removing limits on psychiatric hospital days for comprehensive community care.

Area of Science:

Health Policy
Mental Health Services
Healthcare Economics

Background:

Medicare copayments for mental and physical health care are undergoing changes, moving towards eliminating discriminatory practices.
Despite progress, significant gaps remain in achieving comprehensive mental health parity within the Medicare system.

Discussion:

Medicare must broaden its coverage to include essential mental health services such as case management, psychiatric rehabilitation, and assertive community treatment.
The current system necessitates payment for all behavioral health professionals to ensure integrated care.
The 190-day lifetime limit on inpatient psychiatric hospital days under Medicare is a barrier that needs removal.

Key Insights:

Eliminating discriminatory copayments is a step, but not the entirety of achieving mental health parity in Medicare.

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Expanded coverage for community-based mental health services is crucial for patient well-being and recovery.

Policy reform is needed to ensure equitable access to a full spectrum of mental health care for Medicare beneficiaries.

Outlook:

Future Medicare benefits should encompass vital community services, reflecting a commitment to holistic mental health care.
Continued advocacy and policy development are essential to realize a future where Medicare fully supports mental health needs.
The goal is a Medicare system that provides robust, accessible, and comprehensive mental health benefits, including community-based support.