While some believe the Aetna-Humana merger and the Cigna-Anthem merger will result in lower hospital prices, mental health advocates — who often already face inequalities — are worried they’ll be left out of the equation. One key worry is that insurers will deny mental health claims more frequently than claims for other medical procedures.
U.S. Representative Joseph P. Kennedy III (D-Mass) sent a letter to antitrust officials regarding the mergers. “There’s a gaping hole between the need for mental healthcare and substance abuse care and the ability for patients to get that care,” he said. “My concern is that with continued consolidation in the marketplace, that could get worse and not better.”
Rep. Kennedy also worries bigger insurers would reimburse psychiatrists at lower rates than other doctors, giving them an incentive not to accept insurance.
Another group, the American Psychiatric Association, sent a letter to antitrust officials as well. The APA is concerned the mergers will worsen the idea of “phantom networks.” Through such networks, mental health patients are given a list of doctors and psychiatrists who aren’t taking new patients, aren’t reachable or don’t accept insurance plans.
“Creating mega-insurers threatens to exacerbate the ‘phantom network’ problem by eliminating competition on both the consumer and provider ends of the service chain,” the APA wrote in its letter.
Interestingly, according to data from Mental Health America, the 10 states with the lowest rates of mental illness and highest rates of access to care are in the Northeastern and Midwestern United States. The 10 states with the highest mental illness rates and lowest rates of access to care are in the South and West.
More articles on payer issues:
BCBS of Louisiana targets primary care to reduce hospital costs
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