Benjamin Miller’s Post

Ghost networks are a persistent problem in mental health care. Headway exists to fix this systemwide challenge at its core. We believe that making it easy for providers to actively practice in-network is critically important. By enabling providers to make this choice, health plans can have active networks and gather data that helps members get care. Thanks to Morgan Gonzales at Behavioral Health Business for talking with us about our solution to root out these deep challenges and build a new mental health care system everyone can access. Read more here: https://lnkd.in/gjUuzj5A

Have you ever tried to find any type of healthcare provider or specialist through your health plan's directory only to discover the provider was (1) unreachable, (2) not in-network, or (3) not accepting new patients? If so, you are not alone, as the Office of NYS Attorney General (OAG) recently released a report which showed that 86% of the listed, in-network mental health providers were “ghost” providers. More than one in five Americans live with a mental illness and the OAG’s report paints a grim picture for those seeking or in need of access to mental healthcare treatment. Learn more in my latest piece with Isabelle Bibet-Kalinyak and Jonathan Walzman on how illegal "ghost" networks have exacerbated the mental health crisis.

Recently proposed legislative updates may improve the enforceability of behavioral health parity rules, according to ECGMC’s Katy Shropshire and Kate Middleton. These updates could have significant implications for payers, providers, and patients alike. As we recognize May as Mental Health Awareness Month, it's important to continue the conversation around mental health parity and behavioral health parity. Stay tuned for more updates on this important issue. #mentalhealthparity #behavioralhealthparity #MentalHealthAwarenessMonth

This large-scale study confirms what any mental health patient or clinician could have told you: after decades of mental health parity legislation, in-network care is still too hard to find and behavioral health providers are paid far less than their physical health counterparts. According to the study, BH patients are 3.5x more likely to get BH care out of network, and the BH provider they receive care is getting paid 75 cents on the dollar relative to their non-BH colleagues. Check out the full article below to learn more. #mentalhealth #behavioralhealth #paritylegislation

So important to recognize and address these and other barriers to care.

We still don't have parity for mental health care. A landmark report just released by the nonprofit research institute RTI International, Behavioral Health Parity – Pervasive Disparities in Access to In-Network Care Continue, documents the barriers that people with mental illness encounter when trying to access mental health care. The report shows how poorly they fare compared to people seeking other medical services and provides state-by-state findings. Key findings: People are forced to seek care from higher cost, out-of-network providers for mental health and substance use treatment — at far higher rates than for other medical and surgical care.  Mental health providers are routinely paid less than other M/S providers.   Out-of-network use was 3.5 times higher for mental health/substance use disorder treatment than for other medical services, similar to the finding from the most recent Milliman report. Learn more: https://lnkd.in/gf9AuAE2

"Individuals struggling with mental health conditions often rely on health plan provider directories to access affordable, quality health care services, and ghost networks can force patients to choose between paying out-of-pocket, which is not possible for many, or forgoing treatment altogether." Read the full story now: https://lnkd.in/ex2vKP2y #MentalHealthAccess #GhostNetworks #HealthcareReform #NYHealthcare #MentalHealthAwareness *This is intended to provide general information, not legal advice. Please contact the authors if you need specific legal advice.

How does your company support the mental health of its employees? The pandemic ushered a trend towards accepting teleheath as a service delivery method in resistant populations. Having worked in healthcare for almost two decades in a rural and frontier area, this was a welcome change - it has increased access for many. Currently 43.2% of Americans get services via telehealth compared to less than 1% at the start of 2020.  The second trend, however is unwelcome... the impact on our population's mental health... "In a recent analysis, the State Of Workforce Mental Health Report shows that 87% of U.S. workers across all industries reported having least one mental health issue, and 65% of employees said their mental health made it difficult to work. Interestingly, when compared with 2023, stress declined as a reported problem (from 51% to 40%) and burnout (20% from 30%). But employees are now reporting an increase in serious mental health issues such as chronic depression, anxiety, substance use disorders, self-harm, and suicidal thoughts. The data show an increase in self-harm (3.3% from 1.4%), suicidal thoughts (5.0% from 3.4%), intimate partner violence (3.0% from 1.4%), and inpatient hospital stays (12.0% from 4.0%). In addition, over half (55%) of the U.S. workforce is supporting a child with mental health challenges; this is more than double those who reported in the prior year (19%)." If this concerns you, and you would like resources, consider subscribing to this industry newsletter:

Top thing on my mind this morning: Ghost providers sounds like a network of evil individuals in a Marvel movie. The reality is that it's providers who are listed as in-network for a carrier & yet end up not being in-network, are not accepting new patients or just don't pick up the phone. The state of New York recently did a massive callout to mental health providers listed as in-network for several prominent providers in the state. Turns out 86% of those providers turned up as "ghost providers." Not great. It's a problem that most likely is being felt on a national scale & one that is going to take a joint effort to address. https://lnkd.in/gk-E9j7U

Mental health spending has surged during the pandemic, reflecting a growing recognition of its importance in overall healthcare. This trend underscores the need for integrated solutions in medical billing and practice management to support mental health services efficiently. At TrustMed Solutions, we're committed to providing comprehensive support for all aspects of healthcare, including mental health. Read more about the increase in mental health spending and its implications from the Axios Article: #mentalhealth #HealthcareSpending #medicalbilling #practicemanagement