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Medicaid Reimbursement for Mental Health Varies Widely Across States

Tom Valentino, Digital Managing Editor

A report released on Monday by researchers from Oregon Health & Science University (OHSU) sheds light on the wide discrepancy in Medicaid reimbursement rates for the same mental health treatment services across different states.

Findings from the study were published in the April edition of the journal Health Affairs.

Medicaid is the largest single payer for mental health services in the US and serves a population that has historically been disproportionately affected by mental health conditions.

For the study, OHSU researchers documented commonly billed psychiatric services and then compared Medicaid reimbursement rates across states. They discovered rates varied by nearly fivefold between states with the lowest reimbursement rates, including Pennsylvania, Rhode Island, and Maine, compared to states with the highest rates, including Nebraska, Alaska, and Arkansas.

The study also found that, on average, Medicaid paid psychiatrists at 81% of rates paid for the same services paid by Medicare, which OHSU noted in a news release “is often seen as a standard for reimbursement.”

“States that are chronically underfunding or underpaying their psychiatrists should take note of where they stand,” study lead author Jane Zhu, MD, assistant professor of medicine (general internal medicine and geriatrics), OHSU School of Medicine, said in the release. “For those states, raising the reimbursement rate may be one tool to increase recruitment and retention of mental health professionals.”

The researchers concluded in their study that reviewing reimbursement rates could be one way policymakers can address ongoing mental health workforce shortages within their states and that comparing Medicaid payment across states could help benchmark ongoing federal and state proposals.

“Reimbursement rates are just one piece of that puzzle,” Zhu said. “We don’t know whether raising reimbursement rates will be effective in improving access to mental health treatment. Increasing reimbursement rates is probably going to be necessary but not sufficient.”

 

References

Medicaid reimbursement for mental health varies widely across states. News release. Oregon Health & Science University. April 3, 2023. Accessed April 5, 2023.

Zhu JM, Renfro S, Watson K, et al. Medicaid reimbursement for psychiatric services: Comparisons across states and with Medicare. Health Affairs. 2023;42(4):556-565. doi:10.1377/hlthaff.2022.00805

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