Court Sets New Parity Standard; United Behavioral Appeals to Supreme Court

The fight for behavioral health parity has momentum heading into 2024 following three major decisions at the appellate level. And the battle may extend to the U.S. Supreme Court following an appeal by United Behavioral Health. Three cases in this slice of the appeals court address how health plans governed by the Employee Retirement Income […]

84% of Americans Say Behavioral Health Parity Is Important

The majority of Americans believe in behavioral health parity and prioritize mental health now more than they have in the past. But they’re not so keen on paying higher premiums to get it. A survey conducted by the health insurance industry group Association for Behavioral Health and Wellness illuminates the popular demand for equal treatment […]

How Biden’s Anti-Competitive Merger Plan Could Impact Behavioral Health

The federal government could begin scrutinizing private equity-owned behavioral health practices. The Biden-Harris administration announced new initiatives to thwart anti-competitive mergers and practices that could increase health care costs for patients. Private equity firms, health insurers and health systems will be subject to additional surveillance to foster competition in the behavioral health sector.  Although still […]

‘This Isn’t Just a Payer Problem’: Health Plans and Providers Must Jointly Address Ghost Networks

More than 80% of mental health provider listings on Medicare Advantage (MA) directories are inaccurate or unavailable. That’s according to a recent secret shopper study conducted by the Senate Committee on Finance. These inaccurate provider directories, also known as “ghost networks,” can cause patients to get pinned down by large out-of-pocket bills and clinicians to […]

Mental Health Now Top Comorbidity for Highmark Members

Highmark Wholecare reports that over a third of its members have been diagnosed with at least one mental health condition. That’s according to a recent analysis of over 420,000 Highmark Wholecare members, which found that mental health disorders have become the most common health condition among its members, surpassing common conditions like diabetes, hypertension, tobacco […]

What Potential Humana-Cigna Tie Up Means for Behavioral Health

An industry-redefining merger of Humana Inc. (NYSE: HUM) and The Cigna Group (NYSE:CI) is reportedly in the works. The deal, if completed, would create a massive company that spans nearly every segment of the health insurance industry. It would also create a formidable clinical and health services division prominently featuring behavioral health. Late Tuesday, a […]

UnitedHealth Group Broadens Behavioral Health Provider Network, Advances Integrated Care Delivery

UnitedHealth Group (NYSE: UNH) continues to escalate its behavioral health business, tacking on tens of thousands of new behavioral clinicians in the last year. UnitedHealth added a whopping 45,000 behavioral health professionals to its network last year as the company continues to push towards integrated care delivery, building off increasing behavioral health utilization, according to […]

‘Payer Ghosting’ Further Straining Behavioral Health-Health Plan Relationship

Dating slang is helping behavioral health professionals describe a troubling evolution in payer relations. Payer ghosting. In dating, someone “ghosts” another person when they abruptly stop communicating despite previous interest. In this context, payer ghosting occurs when payers stonewall providers on claim reimbursement. This can be a trickier challenge for providers than the typical payer […]

‘Where the Money Goes Drives Action’: Florida Blue, SCAN Incentivize VBC Behavioral Health Integration

Payers are trying to figure out how behavioral health fits into the value-based care paradigm as the demand for innovative contracting grows. One of the main places payers are pushing for integration is with primary care. Still, integrating primary care and behavioral health in a value-based care arrangement can be difficult. Primary care providers often […]

Giving Teeth To Parity: New York Paves the Way for More Medicaid Managed Care Oversight

The state of New York fined five Medicaid managed care plans a total of $2.6 million for denying claims or failing to pay for specialty behavioral health services. Other states may start to follow New York’s example. The enforcements were filed after New York’s office of mental health conducted a comprehensive examination of behavioral health […]