Inpatient mental health services at the state’s hospitals are at the breaking point, as demand for services mounts and hospitals are under increasing pressure to cut costs.
Increasing utilization of mental health services is one of many factors pushing up premiums for employers. The state’s mental health parity law increased access to mental health services when it was updated in 2008 to include four new diagnoses: autism, addiction, eating disorders,and post-traumatic stress disorder. The Massachusetts Division of Health Care Finance and Policy estimates that the requirements of the mental health parity law account for 2.2 percent of the health care premium. In addition, the rate of utilization increase in mental health services is outpacing that for non-mental health services. From 2008 to 2009, inpatient mental health utilization rose 3.9 percent versus an increase of just 0.9 percent in non-mental health utilization during the same period. On the outpatient side, behavioral health visits rose 9.6 percent from 2008 to 2009, while other outpatient visits rose 3.8 percent.
“In Massachusetts, 10 percent of members use mental health services, versus 6 percent on average around the country,” Eric Linzer, spokesman for the Massachusetts Association of Health Plans, said. Rates of utilization have likely risen further since 2009, due to increased demand related to the economic downturn, Linzer said.
“Medicaid pays so low that hospitals look to private insurers to make up the difference,” Stuart Altman, Brandeis University professor of national health care policy said. “If private insurers push down the reimbursements for mental health, the hospitals will close beds, they are already closing beds.”