Because a key part of ensuring access to mental health support is ensuring a strong and diverse mental health workforce, the APA Advocacy Office is also involved in efforts to strengthen training and reimbursement. APA Services helped draft the ACCESS in Mental Health Act (H.R. 7924), introduced in March 2024. The bill would provide grants to minority-serving institutions to create or expand graduate programs in mental health fields and would provide grants to students attending these graduate programs. Though the bill did not pass in 2024, getting it introduced laid the groundwork for this year’s efforts: APA Services will be working with a new lead sponsor in 2025 to push the legislation forward.
APA Services has also been working to increase mental health options for Medicare beneficiaries by supporting reimbursements to doctoral interns and postdoctoral residents practicing under supervision. The Accelerating the Development of Advanced Psychology Trainees (ADAPT) Act (S. 2511/H.R. 9138) and Increasing Mental Health Options Act (S. 669/H.R. 8458) have been introduced in both the Senate and House with bipartisan support in committees with jurisdiction over Medicare, a “critical step forward,” said Scott Barstow, APA’s director of congressional affairs. The office is also lobbying in support of evidence-based integration of behavioral health services into integrated care models that deliver mental health services in primary-care settings. Policymakers are increasingly focusing on integrated care as well as shifting to value-based payment systems and establishing new models of paying for primary care. APA Services is working to ensure patients served by new payment models get the behavioral or mental health services they need. At the same time, psychology is joining the broader health care provider community in uniting behind efforts to address the continuing failure of Medicare provider payments to keep pace with inflation.
“I think there is a really good chance that discussions across all these fronts lead to progress next year,” Barstow said.
In addition, advocacy efforts are increasingly focused on raising the public’s understanding of why their insurance may offer poor coverage for mental health care. APA has been assisting the investigative journalism organization ProPublica to expose insurance barriers that keep psychologists and other mental health professionals from practicing in-network. More than 500 mental health professionals shared their experiences with ProPublica for the final article, which was copublished with NPR in August (Waldman, et al. ProPublica, Aug. 25, 2024).
“It’s one thing to go talk with payers to say, ‘You need to reimburse people better,’” said Stephen Gillaspy, PhD, director of health and health care at the APA Center for Psychology and Health. “It’s something else if someone in the state legislature reads an article and goes to the health care commissioner.”
APA is also lending expertise to independent organizations drawing attention to insurance coverage gaps. APA helped fund the nonprofit RTI International to look at in-network and out-of-network coverage of mental and behavioral health. That report, released in April, found that patients went out of their health care network 10.6 times more often to see a licensed psychologist than to see a medical or surgical clinician (Mark, T. L., & Parish, W. J., Behavioral Health Parity—Pervasive Disparities in Access to In-Network Care Continue, RTI International, 2024). APA also contributed psychology expertise to a National Academies of Sciences, Engineering, and Medicine report on expanding access to behavioral health care through Medicare and Medicaid (Expanding Behavioral Health Care Workforce Participation in Medicare, Medicaid, and Marketplace Plans, The National Academies Press, 2024). The hope is that these reports give local state psychological organizations a tool for advocacy, Gillaspy said.
“Partnering with psychologists in the states is a force multiplier for our advocacy efforts,” McGuire agreed.
The effort to secure better access to mental health care will continue in 2025. One major goal is to push for an increase in the Medicare Conversion Factor for mental health services. Conversion factors are monetary values on medical services that act as a multiplier for the value for specific services. If, for example, the value for service for 60 minutes of psychotherapy is set at 3.5, the payment would be 3.5 times that year’s conversion factor.
As of 2023, the conversion factor sat at $33.89, barely above the 1992 factor of $31.00. APA Services supports the Strengthening Medicare for Patients and Providers Act (H.R. 2474), which would build in an inflationary index to the conversion factor. That bill was introduced by Rep. Raul Ruiz, MD, (D-CA) in April and is also supported by other professional organizations such as the American Medical Association.
Throughout 2025, APA Services will also continue working to maintain the telehealth access expansions first established during the COVID-19 pandemic by supporting the Telemental Health Care Access Act of 2024 (S. 3651).
This article was written by from www.apa.org
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