Mental Health: How payers may assist in repairing the flawed mental health care system

How payers may assist in repairing the flawed mental health care system

Mental health

According to the Centers for Disease Control and Prevention, the United States’ mental healthcare system is failing as the country’s population’ mental health deteriorates.

Though the systemic issues were also present before to COVID-19, the pandemic brought them to light.

Political anthropologist Eric Reinhart, M.D., of Harvard University’s departments of law, psychiatry, and public health, expressed his belief that society can address mental health needs while also saving money in the long term.

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Reinhart believes that since there aren’t enough psychologists and psychiatrists in the nation, it could be time to de-professionalize the delivery of mental healthcare and let laypeople fill in the gaps. But in order for this to succeed, those individuals must be compensated for their work.

According to Reinhart, the Centers for Medicare & Medicaid Services (CMS) has tested paying community mental health personnel. But, it achieved this by attaching that support to routine medical visits; in other words, a patient must obtain a doctor’s note before visiting a lay mental health provider.

Reinhart told Fierce Healthcare, “What that does is it uses the public health model of a community health worker, but it traps it within the medical model.” “And that severely limits your options.”

He said that commercial health plans would be more effective in bringing community-based healthcare that depends on laypeople to reality. He claimed that because private insurers are less susceptible to lobbying by the healthcare sector, they would be more motivated.

Additionally, Reinhart stated that a large portion of the work performed by such laypeople would fall under the category of preventative health, which, according to multiple studies, when done properly, saves the system billions of dollars.

According to Reinhart, “this is an ideal thing to do if you’re a private payer and you’re trying to reduce the healthcare costs of the people that you’re covering.” “You ought to be advancing far more quickly than CMS.”

He stated that he envisioned community-based mental health facilities mostly manned by locals. Rather than spending years in medical school, he claimed, these community health workers would just require two weeks to one month of training.

According to Reinhart, “many of the everyday care services that people need but aren’t getting don’t require two years of graduate school in social work.” “Psychiatry degrees are not necessary for them. They don’t demand a psychology doctorate. They only need very minimal training, which can take a few weeks or a month. You know what grandma in the corner needs because you live on the same block.

Because it can provide jobs, communities would gain from both the care provided and the individuals providing it. Reinhart said that when it comes to providing medical treatment, these kinds of community-based initiatives aren’t all that uncommon.

Remarkably, Reinhart remarked, “not so much for mental health.” It is assumed that you require the services of licensed clinical social workers, psychologists, and psychiatrists for mental health issues.

Reinhart referenced the work of University of Pennsylvania’s Shreya Kangovi, M.D., who created the Individualized Management for Patient-Centered Targets, or IMPaCT, community health workers model. She has demonstrated that community-based approaches are effective, he added, but regrettably it is somewhat related to the medical field.

A hospitalized person is matched with a community health worker under IMPaCT, who subsequently follows up with them in the community. Reinhart added, “And they receive very little training, and it’s not expensive to incorporate.” What she demonstrates is a significant decrease in both hospital stays and costs over the course of only one year. However, she admitted that it has been very difficult to convince health systems to adopt this model since they lack the necessary financial incentives.

Reinhart says that’s where payers come in.

“I’m not only optimistic that private insurers will follow CMS, but I think they could even be the ones to push CMS to embrace a public health model of prevention over a medical one and realize how important it is to pay for these preventative services.”

Earlier this week, Reinhart expanded on his thoughts in a Stat opinion article.