As we begin a new decade, we should all pause and reflect on the tremendous strides that we’ve made as a healthcare industry—and as a country—to advance parity in mental health.
Insurance companies are recognizing the importance of investing in mental health as a part of total health at higher rates than ever before. Clinicians are looking at the “whole patient” in a way that seemed far-reaching just 10 years ago. And, importantly, new generations are proactively talking about their mental health, and in doing so are further breaking down the long-standing stigma that has constructed many of the barriers we face today.
Despite the progress, and parity being the “law of the land,” we still have a long way to go to achieve true parity in practice. If the first phase of parity focused on reducing the insurance and coverage-related barriers to accessing mental health care (which still needs work), this next phase is about making sure people who need mental health care can actually see high-quality providers in the way that’s best for them.
Here’s what we can expect to see in 2020:
1. Leaders in business, technology and healthcare will be more open about telling stories of their own mental health care journey.
The conversation about mental health care has evolved, and with it, leaders are speaking out about their experiences with mental health.
Cultural leaders like Kevin Love and Prince Harry have used the power of narrative to shed light on the importance of open and honest dialogues about mental health, including reducing stigma around care. We’ve also seen business leaders like Aetna President Karen Lynch and AdventHealth CEO Daryl Tol show the courage to be vulnerable and share their own stories. Their employees and colleagues will follow suit, and with courage comes change. I know stories like this have encouraged me to share my own story. I hope others will too.
2. Medical providers will begin to integrate mental health screenings as a part of standard practice, thereby bringing more patients with mental health conditions into the care continuum.
Nearly 1 in 4 people in America have a mental health condition, yet more than half don’t get the treatment or support they need.
Next year, we’ll see mental health incorporated into preventive care at unprecedented levels. When healthcare providers talk with their patients about mental health, patients are better able to get the support they need. Putting mental health first—at scale—will help to ensure people who need mental health care are identified and connected with those resources. As screening practices are adopted, systems and plans will continue to make investments that support medical professionals to connect their patients with the right mental health care.
3. At the state level, we will see providers, payers and regulators recognize the value in reimbursing for telemental healthcare to support access.
When was the last time you FaceTimed or had a video meeting? Probably today. Technology is a commodity, and, as an industry, we've been talking about telehealth for a decade-plus.
There is a provider shortage in mental health care, and telehealth can serve as an effective modality to address this shortage, particularly in rural America. Telehealth for mental health care also is the preferred modality of treatment for many people.
The adoption of telemental healthcare will be the leading catalyst for the vision of telehealth to become the reality. We are beginning to see leadership, including at the state level such as the recent signing of a bipartisan bill in Wisconsin expanding Medicaid reimbursement for telehealth services. As we expand coverage and accessibility to meet patients’ needs and preferences, policy and regulation will stress efficiency, efficacy, and patient safety.
4. Health insurance plans will increase mental health reimbursements to expand their provider networks.
Demand for mental health care is higher than ever: Six in 10 Americans have sought or wanted to seek treatment for themselves or a loved one. At the same time, individuals are having trouble receiving care from in-network providers.
Due to long-standing inequities, including historically lower provider reimbursement, many people face ghost networks when looking for mental health care covered by their insurance. A new study by Milliman found that in 2017 people were 540% more likely to attend an out-of-network behavioral health office visit compared to a medical/surgical primary care office visit.
Health insurance companies know people need better access to mental health care; this will be the year that they make this a reality and begin to reward providers for the care they provide. Plans that move slower than their peers on this trend will be pushed to move faster by their employer customers.
5. The early foundation of value-based care models for mental health will emerge, measuring quality and rewarding providers for better services, not more services.
There is recognition that high-quality mental health care can improve total health and lower cost of care. Yet for decades the shift from fee-for-service to an outcomes-based healthcare system, also known as value-based healthcare, has focused almost entirely on physical health.
This year there will be advancement across the industry to define what quality mental health care looks like, how to measure those domains and ultimately how to build networks that reflect best practices. These quality measures will empower patients to choose providers who are accessible, affordable and have experience treating patients with similar conditions. The measures also will serve as a necessary bridge to rewarding providers based on quality, not quantity.
It’s the start of a transformative decade for mental health care. In 10 more years, people will say 2020 was the year we began to treat mental health care as healthcare.
It’s time the conversation around mental health parity evolved from one focused on access and benefits to sharing information with patients about providers so that they can select the right high-quality mental health care services for their personal needs.
David Wennberg, M.D., is the CEO of Quartet Health. Prior to becoming Quartet’s CEO, David was Quartet’s chief data scientist and led the business development team.