ACA Changes Mental Health Treatment

Mental health is a critical but oft-ignored component of health care. Patients in need of mental health treatment face the double blow of social stigma and lack of insurance coverage, making effective treatment an unaffordable option. Provisions of the Affordable Care Act will make mental health treatment more accessible than before, with the potential to completely overhaul the current mental health system.

Insurers have traditionally excluded mental health coverage from their health plans, citing mental issues as a pre-existing condition. With costs as high as $150 or more for a single office visit – not counting costly prescription medication – many more patients are forced to go without care in lieu of paying those costs out of pocket.

The ACA, however, includes mental health in its list of ten Essential Health Benefits and will require insurers to offer coverage on par with other medical and surgical benefits. This will not only benefit millions of uninsured Americans with mental health concerns, but also the many insured Americans whose policies do not currently provide equal mental health coverage.

Mental health providers will face a number of challenges in January when the ACA is fully implemented. One major challenge, of course, is the ratio of available providers to the estimated number of newly enrolled patients they will see. A care gap may persist as providers scramble to provide services to as many as possible.

In addition, the inclusion of insurers as payers for mental health care adds a level of complexity to providing care that will drive many solo practitioners into group practices. Solo therapists who collect cash are able to charge higher fees and often save costs associated with billing software and office space, choosing instead to work out of their homes. However, accepting insurance will require them to get up to speed with medical billing and coding and to accept lower fees per session as part of their agreement with insurers.

A larger practice offers cost-sharing benefits in which many professionals can go in together for expensive software and real estate, though working with insurance companies can take away from the autonomy that many therapists currently enjoy. Another possibility, however, is joining a traditional medical practice to create an integrated approach to healthcare. Having a mental health professional in a group practice gives general health providers another diagnostic option that will allow them to provide better – and less costly – care.

Mental health providers considering a shift in their practice can ease the burden of insurance collections with medical receivables factoring. Factoring allows you to turn your claims into immediate cash that you can invest in the necessary software, real estate, and logistics to continue providing quality treatment to your patients. PRN Funding can get you started in a medical receivables factoring program that fits your needs – contact us today to learn more.

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