Nav: Home

Patients insured by marketplace health plan less likely to receive a medical appointment

May 07, 2019

PHILADELPHIA - Among adults with mental health needs, those covered by Medicare or employer-sponsored health insurance have greater access to medical treatment, less out-of-pocket cost and are more likely to receive care than those seeking an appointment through an Affordable Care Act (ACA) Marketplace-sponsored plan, according to findings from researchers at Drexel University's Dornsife School of Public Health. Their study, published in the May 2019 issue of Health Affairs, provides preliminary results on disparities among those experiencing psychological stress since the ACA became law in 2010.

The researchers used National Health Interview Survey data on adults experiencing mental illness. They looked at a dataset that included 4,500 Medicaid enrollees, 8,600 with employer-sponsored insurance and nearly 900 on a Marketplace plan, and measured access to treatment, specifically whether individuals received care in the previous 12 months and whether those patients could afford treatment.

Among those seeking mental health care during the previous 12 months, success was highest for those with employer coverage. Although 5 percent of those with employer-sponsored insurance and 9 percent of Medicaid patients reported trouble getting a mental health doctor appointment in the previous year, 12 percent of Marketplace-enrollees experienced this same trouble.

Additionally, nearly 12 percent of Marketplace and nine percent of Medicaid enrollees - but only four percent of those with employer-sponsored insurance - reported being unable to be accepted as a new patient during the previous 12 months.

Of the 44.7 million adults with a mental illness in the United States, only 43.1 percent received treatment in the previous year in 2016. The ACA mandates coverage of behavioral health services in Medicaid and all exchange health plans, and expands protections in individual and small-group insurance markets.

"Although the ACA added about 20 million people to the number of insured in the United States, significant disparities remain," said lead author Ryan McKenna, PhD, MA, an assistant professor of Health Management and Policy in Drexel University's Dornsife School of Public Health. "Policy makers must look at this data and remedy these barriers for millions of Americans."

The authors propose making health insurance more transparent by developing a metric to measure quality and size of a plan's network, much like the one that exists for Medicare's Star Rating System. Sorting enrollees into plans that fit their health needs more effectively may help lower out-of-pocket and out of network costs for enrollees, the authors suggest.

To combat a shortage of behavioral health specialists participating in various health plans, the authors advise simplifying administrative processes. The researchers note that changing Medicaid organizational procedures may speed up reimbursements to clinicians and lower costs for physicians to accept Medicaid.
-end-
Additional authors on this research include Jessie Kemmick Pintor of Drexel University's Dornsife School of Public Health and Mir M. Ali of the United States Department of Health and Human Services.

Drexel University

Related Mental Health Articles:

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.
The Lancet Child & Adolescent Health: Mental health problems persist in adolescents five years after bariatric surgery despite substantial weight loss
Five years after weight-loss surgery, despite small improvements in self-esteem and moderate improvements in binge eating, adolescents did not see improvements in their overall mental health, compared to peers who received conventional obesity treatment, according to a study in Sweden with 161 participants aged 13-18 years published in The Lancet Child & Adolescent Health journal.
Cigarette smoke damages our mental health, too
The researchers found that students who smoked had rates of clinical depression that were twice to three times higher than did their non-smoking peers.
Many in LA jails could be diverted into mental health treatment
The largest mental health facilities in the US are now county jails, with an estimated 15% of men and 31% of women who are incarcerated in jails nationally having a serious and persistent mental disorder.
The Lancet Child & Adolescent Health: Mental health harms related to very frequent social media use in girls might be due to exposure to cyberbullying, loss of sleep or reduced physical activity
Very frequent use of social media may compromise teenage girls' mental health by increasing exposure to bullying and reducing sleep and physical exercise, according to an observational study of almost 10,000 adolescents aged 13-16 years studied over three years in England between 2013-2015, published in The Lancet Child & Adolescent Health journal.
Can Facebook improve your mental health?
Contrary to popular belief, using social media and the internet regularly could improve mental health among adults and help fend off serious psychological distress, such as depression and anxiety, finds a new Michigan State University study.
A gut feeling for mental health
The first population-level study on the link between gut bacteria and mental health identifies specific gut bacteria linked to depression and provides evidence that a wide range of gut bacteria can produce neuroactive compounds.
Mental health care increasing most among those with less distress
A new study shows that more Americans are getting outpatient mental health care and the rate of serious psychological distress is decreasing.
On-again, off-again relationships might be toxic for mental health
A researcher from the University of Missouri says that the pattern of breaking up and getting back together can impact an individual's mental health and not for the better.
Could mental health apps lead to overdiagnosis?
Mental health app marketing commonly presents mental health problems as ubiquitous and individuals as responsible for mental wellbeing; overdiagnosis and denial of the social factors related to mental health could result.
More Mental Health News and Mental Health Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Uncharted
There's so much we've yet to explore–from outer space to the deep ocean to our own brains. This hour, Manoush goes on a journey through those uncharted places, led by TED Science Curator David Biello.
Now Playing: Science for the People

#556 The Power of Friendship
It's 2020 and times are tough. Maybe some of us are learning about social distancing the hard way. Maybe we just are all a little anxious. No matter what, we could probably use a friend. But what is a friend, exactly? And why do we need them so much? This week host Bethany Brookshire speaks with Lydia Denworth, author of the new book "Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond". This episode is hosted by Bethany Brookshire, science writer from Science News.
Now Playing: Radiolab

Dispatch 2: Every Day is Ignaz Semmelweis Day
It began with a tweet: "EVERY DAY IS IGNAZ SEMMELWEIS DAY." Carl Zimmer – tweet author, acclaimed science writer and friend of the show – tells the story of a mysterious, deadly illness that struck 19th century Vienna, and the ill-fated hero who uncovered its cure ... and gave us our best weapon (so far) against the current global pandemic. This episode was reported and produced with help from Bethel Habte and Latif Nasser. Support Radiolab today at Radiolab.org/donate.