Many commercial and Medicare Advantage plans use Medicare fee-for-service rates as a benchmark for most medical services, but a new study showed those rates aren’t comparable for mental health services.
Modern Healthcare: Commercial Plans’ Lower Rates For Mental Healthcare May Reduce Patient Access
Commercial and Medicare Advantage plans pay mental health providers in their networks significantly lower rates than traditional Medicare pays, which likely reduces access for patients, Congressional Budget Office analysts found. Using claims data from the Health Care Cost Institute, the researchers found that average in-network rates for two categories of common mental health services in commercial and Medicare Advantage plans in 2014 were 13% to 14% less than fee-for-service rates in traditional Medicare. (Meyer, 2/5)
In other news on Medicare —
Politico Pro: Private Medicare Plans Face Few Threats From 2020 Proposal
The Trump administration’s proposed 2020 payment policies for Medicare Advantage seem unlikely to blunt the program’s sustained growth. The proposal issued last week contained few unwelcome surprises for insurers, though it’s likely to rekindle annual lobbying battles that have intensified as the program has grown to over $200 billion a year. (Demko, 2/6)
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