Beginning January. 1, over 65 million Americans who depend upon Medicare will have greater access to coverage for mental health.
Medicare is now able to cover therapy appointments with certified counsellors for marriage and families and professional licensed counselors. They are two kinds of therapists that represent about 40% of master’s-level mental health professionals across the nation according to the American Counseling Association.
Victoria Kress, a professor at Youngstown State University and a licensed professional counselor, talked to All Things Considered host Juana Summers about how the new law may affect providers and patients.
The interview was edited lightly to increase clarity and length.
Interview highlights
Juana Summers: This is an obvious solution I must say. There’s a large number of people who require the access to medical services -and by that, I’m referring to Medicare recipients. And there’s another large provider group that is qualified to provide this service. Why did it take this long for this law to be passed?
Victoria Kress The past few years have seen numerous variations of licensure and legislation that has been proposed, as well as numerous legislative strategies and strategies have been employed to get us on the table and achieve this goal.
I believe it was money. When I sit down in the presence of legislators, their initial question they’d want to ask is “What are the costs of this as? How will this impact our financial situation?” Obviously, when you are able to access more health care and more providers providing services, it’s going to raise the costs.
I believe that with COVID as a pandemic it put a spotlight on mental health concerns. A lot of people started to realize the importance of access to health care is for mental health concerns. This is why I think that legislators were feeling pressure to offer treatment for people who are on Medicare.
summersWe need to be open here. The demand for mental health care in this country is acute. It is estimated that the Department of Health and Human Services estimates that more than 169 million Americans live in a region with the shortage of mental health professionals. How much reduction could this make on what appears to be a huge demand?
Kress: It’s profound. It’s true that about 50% of America lives in a region where there is a huge shortage of service providers. And I’m able to tell you that, as a person who lives in a city that even in cities, people are working hard to find the right providers to meet the growing demand for our services.
That’s 18 percent of Americans are covered by Medicare and are expected to soon be able to access numerous providers. This is extremely exciting, particularly when you consider rural areas where one-third of the population are eligible for Medicare services. And with an extremely low supply of providers. It’s will be beneficial to the rural areas.
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Another thing we do not think much about is addiction. A lot of people in America suffer from addiction. Many seniors and those who suffer from chronic disabilities are afflicted by addictions. Around a third of all inpatient hospitalizations due to opioid use disorders are covered by Medicare. The counselors are the principal source of all addiction counseling services. It’s been a challenge for those who suffer from addictions to access services. With counselors now capable of providing the same services we’ve been trained to offer in the future, it’s going to provide opportunities for people to seek addiction care too.
summers Medicare reimburse rates for therapists are considerably lower than the rates some therapists charge out of their own pocket. A single session could run into the hundreds for high-demand providers. Are you concerned that, even when they’re eligible counsel, they may not be willing to accept Medicare due to the lower rates for payment?
Kress: Yeah, absolutely. Also, with the legislation changes that counselors as well as therapy for marriage and families are expected to earn around 75 percent of the amount psychologists earn. This is a deterrent.
It’s an a constant challenge to find ways to get providers to join Medicare reimbursement. But, you know that we face difficulties in continuing to inspire people to get into mental health-related professions. Education professionals have a responsibility to keep pulling people into the field and train to meet the demands that exists. Counseling is among the most demanded professions in the present, and there’s a huge shortage throughout the nation.
SummersI need to recognize that before I even ask this question that certainly, seniors aren’t the only Medicare beneficiaries, but they make up the majority of that group. We are aware they have mental health requirements are complex, and seniors have faced challenges to accessing medical care for their mental health for a long time. In what way do you consider that Medicare insurance for professionals and families therapists can assist in filling the gaps in this particular group?
Kress The counselors we employ are specially equipped to meet the requirements of people who are older. As counselors, we’re trained and support for individuals across the life span. We’ve been unable to assist older adults despite our education due to issues with Medicare reimbursement. This is very thrilling.
One thing that differentiates counselors in comparison to others in the field of mental health is the fact that our focus is upon mental wellness. This means that we are focused on strengths of individuals as well as their resources and capabilities within themselves, within their families, in their communities and even within society. We then focus on those and integrate them in to our plans for treatment as well as how we help people make the changes they wish to see happen.
So I think that our attention to developments and our emphasis on mental health, our emphasis on holistic health and our emphasis on wellness is unique to the population of older adults. I believe it connects with people in this group. We believe that our presence on the market will be very well-received.
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