With employer health plans on the front line of treating mental health and substance use disorders, Mercer was selected to participate in a White House policy roundtable on September 9 titled “Turning the Tide – Improving Access to Addiction Care and Overcoming Obstacles to Parity.” The event featured presentations and open discussion among officials from the White House Office of National Drug Control Policy (ONDCP) and the Department of Labor, as well as representatives from the employer community, insurers, and medical providers.
ONDCP Director Jim Carroll cited the devastating effects of substance use disorders and said "more Americans than ever before need access to effective addiction treatment through their insurers and health plans." He went on to note that not addressing substance use and mental health conditions in the workforce “is far more costly than providing access to quality care.”
Mary Kay O’Neill, Senior Clinical Advisor for Mercer Health & Benefits, spoke on a panel at the event titled "Challenges to Success – Barriers to Care Access and Parity.” Although “ready access to high-quality [behavioral health] providers is the goal,” she noted that network adequacy remains a challenge. O’Neill and other commenters cited a number of reasons, including provider capacity and the relatively high number of providers who opt not to join networks and accept only cash payment.
O’Neill and others also noted that, while there are widely recognized standards of care in many areas of medicine, this is too often not the case when it comes to mental health and substance abuse treatment.
Better, mandatory accreditation standards could help, O’Neill said, but she stressed that more needs to be done to encourage payments to providers for episodes of care that encourage a holistic approach and “puts the person at the middle of treatment.” Providing “pathways of care coming out of emergency treatment” once a patient is stabilized is particularly important and can help achieve better long-term outcomes, she noted.
Commentators also noted that the goal of parity laws is only meaningful if health plans are properly implementing them, consumers and providers understand how they work, and the government provides clear guidance, which hasn’t always been the case. To that end, the US Departments of Labor, Treasury, and Health and Human Services released related guidance on September 5 in the form of final frequently asked questions (FAQ) guidance, and a final model disclosure request form that can be used by health plan members to request information from the plan about parity requirements.
In closing the event, Director Carroll said potential next steps could include another, similar event to get more input on additional ways to improve access to mental health and substance abuse care.