Mental healthcare reform for seniors has moved sluggishly throughout the years, contrasting sharply with the high pace of development for services tailored towards younger generations. As seniors often experience a heightened severity of behavioral health issues due to the presence of coexisting conditions and unstable support systems, this slow-moving progress fails to meet their evolving needs. Thus, governmental regulation and insurance policies must collaborate to optimize accessibility of mental healthcare for all those 65 and older, with an increased focus on Medicare beneficiaries.

Below, we take a look at these issues and some potential solutions highlighted in Corporate Insight’s report on unique and innovative features from Medicare firms.

An Absence of Providers

Forty-five percent of psychiatrists and 54% of psychologists currently do not accept Medicare, the highest non-participation rate among any medical specialty. With the nation facing a growing deficit of psychiatrists, the absence of so many mental health practitioners from Medicare networks further compounds the issue of accessibility. Recognizing this deficit, this year the Center for Medicare and Medicaid services (CMS) enacted policy to expand the eligibility of Medicare providers, allowing marriage and family therapists and licensed mental health counselors to enroll. The question is, will they? The new policy aims to address physician shortages in the field, but some doctors have mentioned bureaucratic hurdles and low reimbursement rates as potential barriers to participation. With provider willingness uncertain, Medicare beneficiaries may continue to face a shortage in mental healthcare. This creates an opportunity for payers to provide supplementary resources and bridge the gaps left by the current system.

How Payers Can Provide Support

To effectively support Medicare beneficiaries, insurers must first grasp how to engage with this demographic. CI’s 2023 Healthcare Consumer Survey shows 51% of beneficiaries search for health coverage information directly from the health insurers’ websites. Payers can leverage this high usage by incorporating actionable behavioral health resources into their informational and wellness programs.

This chart shows how Boomers get their health information

CI’s November 2023 Unique and Innovative Features Report(subscription required) specifically recommends payers partner with third-party mental health and substance abuse platforms to connect their users to subsidized supplementary care. As traditional mental health coverage is often critically limited in terms of parity and network availability, these external resources expand access to care without incurring a substantial cost to the beneficiary. Offering membership to fitness programs such as SilverSneakers has also shown to decrease feelings of social isolation and loneliness in seniors, preventing budding behavioral issues from spiraling into more serious health concerns. Studies have shown participation in such programs lowers healthcare costs for participants, creating a financial surplus members can invest into additional mental health wellness programs or put back in their pockets.

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Aetna Member Site Mental Health Virtual Care Page

Implementation of health assessments that produce personalized recommendations can be highly valuable to users just beginning to explore their behavioral health needs. According to the Unique and Innovative Features Report, users value interactive features and a customized experience—mental health assessments integrate these factors, boosting individual health outcomes by creating the opportunity for timely diagnosis and treatment. Early identification, however, is only half the battle. Informed by assessment outcomes, insurers must guide users towards tailored support, such as the aforementioned third-party platforms. For instance, BCBS of Massachusetts offers members a membership to Learn to Live, a confidential online Cognitive Behavioral Therapy program that helps users evaluate their issues with an identification assessment. From there, members are pointed towards resources aligned with their individual results. Insurers should create incentives to participate in these external wellness programs through additional benefits, as the upfront preventative costs often offset the costs of delayed treatment. While digital assessments cannot substitute for a clinician’s mental health assessment, done correctly these evaluations create a path for Medicare beneficiaries to seek relevant resources, addressing initial questions they may have when confronting their symptoms.

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BCBSMA Mental Healthcare Options Page Self-Guided Online Tool Section

 

This screenshot shows the Learn to Live program introduction screen
Learn to Live Program Introduction

As mental healthcare becomes a leading issue for all age demographics, beneficiaries are actively prioritizing robust coverage in both Medicare and Health Plans. To learn more about how insurers can keep pace with changing consumer preferences, check out our research services in four areas: Health Plan, Medicare, Health System and Pharmacy. For deep dives on specific topics, look to our Healthcare Briefings and don’t forget to check out our Insights section for more industry trends and best practices in the healthcare space. And contact us for access to the Unique and Innovative Features report.