Health plans

Pandemic is a mental health crisis, but some health plans and insurance companies are ‘running out’ of coverage, report says

Too many health plans and insurance companies are putting mental health coverage behind physical health conditions even as the pandemic puts mental health issues front and center, according to a federal government report on Tuesday.

The health care coverage rules that group health plans and insurers apply to physical and mental health conditions are meant to be on the same footing.

In other words, when it comes to mental health, the specifics of coverage such as co-payments and pre-authorization requirements cannot be more stringent than the current financial rules and limits of treatment which apply to medical and surgical services.

But coverage imbalances that can make mental health services harder to access and more expensive still occur, according to a report from the Department of Labor, Health and Human Services and the Department of the Treasury.

For example, The report cited an unidentified health plan that excluded methadone and naltrexone as treatments for substance use disorders. Two other health plans used the same insurance company, which covered nutrition counseling for conditions like diabetes, but not for anorexia, bulimia and binge eating. Three other plans ruled out an autism therapy that could prove valuable to patients.

After federal officials widened the gaps, changes were made, according to the report. Results from a series of surveys include 26 health plans and issuers who said they were going to make changes to their plans or have already made changes.

The “findings clearly indicate that health plans and insurance companies are not providing parity in mental health and addictions benefits, at a time when these benefits are needed like never before,” the secretary of the Department of Labor, Marty Walsh, in a statement.

Walsh opened on his recovery from alcoholism. “As someone in recovery, I know firsthand how important access to treatment for mental health and substance use disorders is. Enforcement of this law is a top priority for the Department of Labor and a goal that I take personally,” he said in his statement on Tuesday.

The semi-annual report is one of the requirements of the Mental Health Parity and Substance Abuse Equity Act of 2008. The $900 billion stimulus bill lawmakers passed in December 2020 authorized measures, including a second round of stimulus checks, and it also armed federal agencies with more enforcement. tools related to the 2008 law on parity between physical and mental health.

In addition to the physical health risks of the pandemic, the past two years have posed mental health risks, including burnout and addiction. More than 100,000 people died from drug overdoses in the 12 months to April 2021, according to the US Centers for Disease Control and Prevention. That’s an increase of almost 30% year over year.

Mental health issues are also a problem in the workplace. Depression results in 200 million lost workdays in America at a cost of $17 billion to $44 billion, according to the CDC.

The new federal report shows the gaps in mental health treatment, but it’s not the only place to spot the gaps.

Employers say mental health is top priority for 2022

The vast majority (86%) of employers said tackling their workforce’s mental health, stress and burnout issues was a top goal for 2022, according to a new survey from WTW WTW,
the human resources consulting firm previously called Willis Towers Watson.

Nevertheless, 49% of survey respondents have not formally established their strategy, while 25% have already presented and adopted strategies to improve the well-being of their workforce.

Monday’s survey questioned more than 300 employers who had a total of 5.3 million workers in their ranks.

In a tight labor market, companies can try to turn their employee wellness programs focusing on mental, physical and financial health into something that hooks and retains staff, said Regina Ihrke, senior director, health and benefits at WTW.

“For years, employers have used financial rewards to encourage employees to take action for their own well-being; however, because these incentives have often failed to change employee behavior, employers are looking for new avenues to engage and incentivize employees to take charge of their own well-being,” she said.