At the urging of MHAMD and others, the Maryland General Assembly and the Maryland Insurance Administration have taken important steps in recent years to ensure the proper implementation of the federal Mental Health Parity and Addiction Equity Act. Unfortunately, according to the findings in a groundbreaking new national report, there is still much work to be done. This is the message MHAMD shared at a briefing on January 30 for members of a key legislative committee.
According to an independent report by the Milliman Group, Maryland is among the worst states for access to affordable in-network behavioral health (mental health and substance use disorder) services. The national actuarial firm analyzed three years of insurer claims data from 2013 to 2015, covering approximately 42 million Americans in all 50 states and Washington, D.C.
The data demonstrates that insurers in Maryland are much more likely to provide in-network care for physical health services compared to mental health and substance use treatment services. This limits access to care and results in higher out-of-pocket costs that can make treatment unaffordable, even for those with insurance.
Among the key findings:
- In 2015, Maryland consumers were nearly 1,000 percent more likely to go out-of-network for behavioral health office visits compared to primary care visits. That’s nearly twice the national average, and third worst in the nation.
- Marylanders were 700 percent more likely in 2015 to utilize out-of-network facilities for inpatient behavioral health care compared to those accessing inpatient treatment for physical health care.
The study also uncovered a troubling disparity in reimbursement rates for the professionals treating individuals with behavioral health needs as compared to those providers delivering physical health treatment. In 2015, mental health and substance use treatment providers were paid over 27 percent less than other providers for the very same office visits billed using identical or similar payment codes. This disincentives medical professionals from entering the behavioral health field, exacerbating an existing workforce shortage and further limiting access to care for Marylanders in need.
MHAMD is proud of the work we’ve done in recent years to implement the critically important federal parity law, and we are appreciative of our ongoing partnerships with members of the Maryland General Assembly, the Maryland Insurance Administration and stakeholders in the behavioral health community. Together, we have passed laws and created regulations designed to improve treatment options and availability for individuals with mental health and substance use disorders. We still have a long way to go, but MHAMD will keep working to ensure Marylanders with behavioral health needs have access to treatment when and where needed.