Breaking Down Barriers: How Healthcare Reform is Finally Opening Doors for Mental Health Access
In healthcare, the Federal Government often struggles to get out of its own way.
About 40% of US mental health counseling professionals weren’t eligible for Medicare reimbursement until January 1, 2024.
On that day, the Centers for Medicare & Medicaid (CMS) finally opened the door for 225,000 marriage/family therapists and licensed professional counselors to care for the country’s 66 million Medicare beneficiaries.
It took 40 years of advocacy to correct a damaging rule that represented yet another unnecessary barrier that prevented millions of our neighbors from receiving mental health and addiction care.
This had exacerbated a growing mental health crisis among older adults, affecting rural communities disproportionately. Adults over 65 years of age represent 17.5% of the population in rural communities compared to 13.8% in urban communities.
Last week, Pennsylvania Senator Bob Casey introduced a bill that could further improve access to mental health supports among rural and frontier populations.
He introduced the Community Health Worker (CHW) Access Act, which bolsters Medicare reimbursement for CHWs and supports their integration into services for Medicaid recipients.
A University of Pennsylvania study was published in Health Affairs demonstrating that a $1 investment in a CHW program yielded a $2.47 return on investment. The 2020 article highlighted a savings of $4,200 per Medicaid beneficiary annually.
According to a 2023 KFF report, 29 state Medicaid offices were funding CHW programs, at least in part. The report indicated that several additional states were planning to join those ranks.
CHWs have been shown to effectively serve as clinician-extenders and care coordinators in hard-to-reach places, addressing social determinants of health and lowering structural barriers to care.
There are currently studies underway to evaluate the ability of local CHWs to enhance the delivery of telemental health care into remote communities.
The inconsistent and fractured approach to deploying CHWs nationally is damaging to our ability to deliver healthcare into underserved communities. Let’s hope that it doesn’t take another 40 years of advocacy to mobilize CMS resources.
