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Study Finds Dramatic Variation in Medicaid Reimbursement Rates for Mental Health Treatment
Medicaid reimbursement rates for mental health treatment varies by as much as five times, depending on the state where people live, according to new research from Oregon Health & Science University. (Getty Images)
Medicaid reimbursement for mental health treatment varies widely across the United States, with differences of up to fivefold, according to a new study by researchers at Oregon Health & Science University. Published in the April edition of the journal Health Affairs, the study highlights the substantial differences in rates of reimbursement for the same services. The study also compared state Medicaid rates with Medicare rates, finding that Medicaid paid about 80% of the same services paid under Medicare. Medicaid is the largest single payer for mental health services in the country but many providers refuse to accept patients covered by Medicaid, despite its coverage of a population disproportionately affected by mental illness.
Barriers to Access
The new study adds to mounting evidence of significant barriers to mental health care in the United States. Doctor Jane Zhu, assistant professor of medicine (general internal medicine and geriatrics) in the OHSU School of Medicine, notes that “states that are chronically underfunding or underpaying their psychiatrists should take note of where they stand. For those states, raising the reimbursement rate may be one tool to increase recruitment and retention of mental health professionals.” However, she also acknowledges that raising reimbursement rates alone is unlikely to be sufficient to resolve the funding and staffing shortages that plague the mental health sector.
Shortfalls in Oregon
Oregon is one of several states considering raising reimbursement rates for behavioral health services in Medicaid. The Oregon Health Authority recently approved a 30% increase in reimbursement rates for certain providers. Last year, Oregon ranked in the lower half of states in terms of Medicaid reimbursement rates compared to other states. Funding and workforce shortages afflict behavioral health services nationwide, including in Oregon.
Jane Zhu, M.D. (Courtesy)
Research Methodology
The study compared commonly billed psychiatric services across states and documented the Medicaid reimbursement rates for these services. Researchers used the recently available Transformed Medicaid Statistical Information System Analytic Files (TAF) to collect the data. OHSU researchers Stephanie Renfro, Kelsey Watson, Ashmira Deshmukh, and John McConnell were co-authors on the study along with lead author Jane Zhu. The research was supported by the National Institute of Mental Health of the National Institutes of Health.
