For Immediate Release - June 30, 2015

AG Healey Report: Barriers Remain for Patients Seeking Access to Mental Health Care and Substance Abuse Treatment

Current Approaches Separate Behavioral Health and Physical Care, Challenging Coordination of Patient Care Efforts; AG Makes Recommendations to Advance Access

BOSTON – A new report pdf format of June 2015 Health Care Cost Trends & Cost Drivers Report
file size 1MB issued today states that current approaches to managing behavioral health care complicate efforts to better coordinate patient care over time and across settings, Attorney General Maura Healey announced today. According to the report, health care benefits are categorized as either “behavioral health” or “medical,” a distinction that complicates efforts to better coordinate overall patient needs.

“During this public health crisis, it is more important than ever that we break down the barriers to patients seeking access to mental health care and substance abuse treatment,” AG Healey said. “In 2015, we should be treating access to mental and behavioral health the same as we treat access to treatment for a heart condition or diabetes. I look forward to working with all stakeholders to address the issues identified in this report.”

This is the fourth report pdf format of June 2015 Health Care Cost Trends & Cost Drivers Report
file size 1MB the AG’s Office has issued in its ongoing work to examine health care cost trends, but the first to focus on behavioral health.

The new report shows the consequences of drawing a distinction between health care benefits that are “behavioral” versus “medical,” when for patients there is no such bright line in their health care needs.

As a result, the report finds that the distinction causes a ripple affect across current approaches to care and recommends that policymakers and stakeholders take a closer look at payment rates for behavioral health services, reassess financial arrangements that make it difficult to coordinate patient care, and work to improve data reporting for behavioral health. The report’s key findings include:

Current approaches to managing behavioral health benefits and reimbursing providers pose challenges for effective care coordination.  

In most cases, there are two separate systems for managing behavioral health and medical services, making it difficult for doctors treating the same patient to easily communicate.

Additionally, many financial arrangements fail to provide meaningful incentives to integrate the delivery of behavioral health and medical services. Current approaches leave little room to improve historically low reimbursement rates to providers of behavioral health services.  These inadequate rates can constrain investment in behavioral health ultimately impacting consumer access to care.

Behavioral health data lags compared to other areas of care, challenging efforts to promote parity.  

The report shows there is an inconsistent amount of information on prices and payment methods that impairs the Commonwealth’s ability to evaluate payment levels and trends, impacting important policy and planning functions.

Furthermore, when behavioral health spending is actually reported, it is often laden with inconsistent definitions and methodologies that make the information difficult to compare. Also, there are often gaps in behavioral health quality metrics, constraining effective measurement and analysis of the quality of behavioral health care.

For more details on the findings of today’s report, visit AG Healey’s website. Prior cost trends reports from the AG’s Office are available here

In the prior three reports, the AGO showed how increased health care costs are tied to market clout rather than the value of services provided, and highlighted how different health care reform initiatives can be in tension with one another. 

This examination was conducted by Assistant Attorneys General Courtney Aladro and Emily Gabrault, Legal Analyst Robert Ciccia, and Division Chief Karen Tseng, all of Attorney General Healey’s Health Care Division.

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