While “we all hoped” mental health parity would achieve cost savings and improve payment of mental and physical health services, as well as workforce and access issues, there are limited savings seen when applying parity to these services for children. In addition, the study by Dr. Kennedy-Hendricks and associates revealed overall mental health spending and use more than doubled, which remains unexplained by parity, James M. Perrin, MD, said in an editorial.
He said, “the bottom line is that parity has some (but only limited) impact on the access to and costs of mental health services.” Other efforts, such as those to help prevent mental health conditions and integrate treatment of mental and behavioral health with the rest of pediatric health care, should be considered.
Can mental health parity still play a role? “The current study offers some hope, although it also suggests the need to monitor and enforce parity better than what seems to have occurred at least in its early years,” Dr. Perrin said. “Parity seems less likely to improve preventive efforts unless mental health benefits clearly support the many effective preventive interventions.”
“With a growing emphasis on the importance of mental and behavioral health and their influences on many other aspects of the health of children and adults, it may be time to think more imaginatively about health care financing that can better ensure attention to mental health concerns broadly,” he said. While new alternative payment models may help bridge the gap, this study emphasizes the need to improve the way in which mental and behavioral health care is paid.
Dr. Perrin is at the MassGeneral Hospital for Children and Harvard Medical School, both in Boston. He reported no relevant conflicts of interest. These comments summarize his editorial accompanying the article by Dr. Kennedy-Hendricks and associates. (Pediatrics. 2018 Jul 23. doi: 10.1542/peds.2018-1572 ).
