Prescriptions for a Better Health System
The report “Financing the Care of Individuals With Serious Mental Illness” offers the following advocacy recommendations to forge a system in which people with serious mental illness have access to the care they need.
On the most global level, advocates should work to achieve parity of health insurance benefits for all psychiatric patients under all payers. Other ideas for advocacy include these:
Revocation of the institutions of mental disease exclusion under Medicaid in order to better support state and county hospitals and staunch the flow of seriously ill patients into nursing homes. | |||||
Reasonable Medicaid and Medicare rate structures for the reimbursement of outpatient, clinic, and rehabilitative services in order to support an ample and high quality system of care. | |||||
Timely Medicare and Medicaid eligibility determination and reinstatement, beginning before release from long-term hospitalization or prison. | |||||
Responsible pharmacy benefit management that promotes good patient outcomes. | |||||
Clinical quality management requirements in fee-for-service Medicaid and for all publicly funded services. | |||||
Collaborative purchasing among federal, state, and private agencies to create comprehensive benefit packages. | |||||
Higher income and asset limits and the inclusion of optional Medicaid benefits, such as psychosocial rehabilitation and targeted case management for states pursuing benefit expansions under Health Insurance Flexibility Act waivers, along with graduated mechanisms for cost sharing such as premiums, copayments, and fiscal management structures that help assure appropriate service use. | |||||
Alternative reimbursement structures to support progressive and efficient clinical practice and adequate ambulatory alternatives to institutional care. | |||||
The report also made recommendations concerning regulations and services for people with disabilities.
