A new study has revealed that a Medicare program aimed at improving healthcare and reducing costs has not resulted in any improvements in mental health care. This nationwide program provides financial incentives to doctors and hospitals, but according to research from Washington University School of Medicine in St. Louis and the Yale School of Public Health, it has not made a difference in mental health outcomes.
The study focused on Medicare beneficiaries from 2016 to 2019 and found that there were no significant differences in mental health outcomes between beneficiaries enrolled in traditional fee-for-service programs and those participating in accountable care organizations. Accountable care organizations, established under the Affordable Care Act, are networks of healthcare providers designed to oversee the comprehensive healthcare needs of specific patient groups. Despite their intended purpose of improving health outcomes and reducing costs, the study found that they have not effectively advanced mental health care.
Senior author Kenton Johnston, Ph.D., stated, “Accountable care organizations are the most important payment and care model in Medicare right now and they do not appear to have improved mental health treatment for the two most prevalent mental health conditions in our society, which are depression and anxiety disorders.”
The study also revealed that individuals with depression or anxiety, particularly those in accountable care organizations, sought less outpatient mental health care. This is concerning, especially given that accountable care organizations receive compensation based on each patient’s medical complexity, regardless of the actual cost of their care. While the goal of these organizations is to control costs while maintaining or improving care quality, the study shows that they have had no effect on the quality of mental health care.
The findings of this study, led Jason M. Hockenberry, Ph.D., were published in the journal Health Affairs. The hope is that this research will prompt policymakers to consider mental health quality measures more carefully, especially in light of recent guidelines for mental health care from the Department of Health and Human Services.