Vizient, Inc. has unveiled a report shedding light on significant gaps in behavioral health treatment between Medicaid and commercially insured patients. The findings reveal disparities in access to crucial services, with Medicaid recipients notably less likely to receive comprehensive care compared to their commercially insured counterparts.
The report, conducted by the Vizient Research Institute, analyzed claims data from 14 states encompassing 12 million covered lives. It focused on patients aged 0-34, stratified by gender and adult status, across five key diagnoses related to behavioral health conditions.
Erika Johnson, Vice President of Strategic Research at Vizient, underscored the study's key takeaway, stating, "The results of this study demonstrate differences in access to care by payer." Johnson highlighted that Medicaid patients, across both adult and pediatric populations, were disproportionately reliant on pharmaceutical interventions alone, lacking access to vital psychotherapy services.
For instance, among females aged 0-17 diagnosed with anxiety and personality disorders, Medicaid-insured individuals were twice as likely as their commercially insured counterparts to receive only pharmaceutical treatments without psychotherapy. Similarly, for males aged 18-34 diagnosed with persistent mood disorders, Medicaid patients were significantly less likely to receive psychotherapy in conjunction with pharmaceuticals compared to those with commercial insurance.
Moreover, the report underscored the ramifications of inadequate treatment access, particularly in exacerbating emergency department (ED) utilization. Data from the Vizient Clinical Database revealed that both adult and pediatric Medicaid patients had significantly higher rates of ED visits for behavioral health concerns compared to commercially insured patients. Additionally, Medicaid patients were more prone to multiple ED returns for ongoing behavioral health needs.
“Providing a fair and appropriate standard of care across all patient populations means expanding provider access for mental health services across all types of payers,” Stephanie Snider, consulting director, intelligence for Vizient said. “Some hospitals are utilizing social workers, nurse practitioners and physician assistants to close the gap in care. By expanding access earlier on, patients are less likely to need to use the emergency room for care, thereby delivering better patient care and saving money for insurers at the same time.”
The Vizient Research Institute conducts rigorous quantitative research with a focus on broad healthcare economic trends affecting the affordability and sustainability of our healthcare delivery system. View Shining a light on disparities in mental health services.
