Mass. AG calls for better coordination of behavioral, mental healthcare

Massachusetts Attorney General Maura Healy is drawing attention to the vast gaps that persist between medical care and behavioral health, mental health and substance abuse services, despite the state's shift toward global payments, according to wbur's Common Health Reform and Reality.

"We need to get to a place where we treat people who've got mental health, substance abuse issues in the same way we treat patients with diabetes or with cancer or with broken bones," Ms. Healy said, according to the report.

Ms. Healy's first healthcare cost and trends report documents the behavioral health benefits and low health insurance coverage rates for these services in Massachusetts. The report reveals the substantial differences between payments made to high- and low-cost hospitals.

According to the report, 79 percent of Massachusetts residents enrolled in MassHealth or ConnectorCare have coverage that separates general medical care from substance abuse treatment and mental healthcare. For members of commercial health plans, 31 percent of members are enrolled in plans that make this distinction.

Even as more healthcare organizations enter into global payment systems, the continued separation of physical and behavioral health eliminates the incentive for physicians from each realm of medicine to work together. Ms. Healy's report outlines the state's need to create "meaningful financial incentives" that will encourage insurers, hospitals, physicians and nurses to "integrate the delivery of medical and behavioral services," according to Common Health Reform and Reality.

However, Health and Human Services Secretary Marylou Sudders said Massachusetts needs to prioritize fixing the payment gaps between high- and low-cost hospitals. Many hospitals and physicians lose money on behavioral healthcare. Hospitals that admit patients for mental health or substance abuse treatment lose 28 cents for every dollar spent on those services from 2010 to 2013, according to the report. In outpatient care, the loss was 45 cents on the dollar.

At the same time, not treating addiction or mental health issues is expensive. Patients who have asthma and anxiety, or another combination of a medical and behavioral health problem, spend between two and two-an-a-half times more on healthcare than patients with just a medical condition.

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