WEEKLY UPDATE: 11/21/24
The Connecticut Hospital Association (CHA), on Monday, November 18, issued a statement in response to the findings of the final report of the Connecticut Office of Health Strategy (OHS) study on Behavioral Health Insurance Coverage and Payment Parity in HUSKY, Private Insurance, and Medicare Advantage pursuant to Public Act 22-47 §§ 57-58, An Act Concerning Children’s Mental Health. The study highlights persistent issues in parity for behavioral healthcare tied to low Medicaid reimbursement rates.
The newly released report reinforces what providers already know and have been sounding the alarm to address: Medicaid underpayment is straining and limiting access to both behavioral health and medical services. In its statement, CHA emphasized the state can take important steps to enhance the accessibility and affordability of behavioral healthcare, starting with sufficient Medicaid reimbursement rates, to ensure all patients receive the right care in the right setting.
“There is a behavioral health crisis. We see it every day in hospital emergency departments, which are often the only option for people who cannot access care in more appropriate settings,” CHA’s statement reads in part.
In an interview with CT Mirror, Mark Schaefer, CHA vice president of system innovation and financing, noted the report’s scope is limited, leaving a void of data on individuals who seek treatment but can’t afford it. “We don’t know how many people weren’t able to get the care they needed, when they needed it, and for how many people it was because they had to bear too great a share of the cost,” Schaefer said.
The OHS report confirms the findings of an analysis published by the Connecticut Department of Social Services (DSS) earlier this year that revealed Connecticut’s distressingly low Medicaid reimbursement rates lag significantly behind other states, putting substantial financial pressure on providers caring for Medicaid beneficiaries. According to the DSS study, behavioral health providers are among the most underpaid by the state, with a startling 92% of Medicaid payments for behavioral health services falling well below the peer-state benchmark. The combined results of both reports form a clear conclusion: The state’s chronic underfunding of the Medicaid program creates barriers to healthcare access for low-income residents and drives higher healthcare costs for employers and consumers.
Connecticut hospitals continue to advocate for policies that will help caregivers address deficiencies and disparities across the system, including establishing Medicaid rate structures for initiatives such as children’s behavioral health urgent care centers, making emergency mobile psychiatric services available statewide during high-demand times, expanding community-based and school-based services to all areas of the state, and implementing Medicaid reimbursement for care coordination initiatives, including but not limited to collaborative care model (COCM) services and community care teams (CCTs).
Click here to read CHA’s full statement.
