Mental Health Parity: Participate in health care policy development to influence nursing practice – Solved Essay

This article provides a sample essay on Mental Health Parity. Permalink: https://premiumacademicaffiliates.com/mental-health-parity premiumacademicaffiates.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us.

The benchmark assesses the following competencies:  Participate in health care policy development to influence nursing practice and health care. Research public health issues on the \”Climate Change\” or \”Topics and Issues\” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population. Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Solution

Mental Health Parity

Description of Policy Health Issue Over the years, significant efforts have been made to remove barriers to mental health and healthcare frameworks that support the provision of mental health. The American Public Health Association (APHA) (2019) notes that to improve access to care and eliminate barriers, mental health parity with other aspects of care is required. Mental health parity calls for the equal treatment of mental health conditions and substance use disorders as other medical care in the insurance coverage (Horgan et al., 2015). Mental health parity promotes equity in health and treatment while also contributing immensely to addressing prevalent challenges such as suicide. The policy area is devised to curb the issues of insurance services covering mental health issues differently than other medical care. Hence, insurers and employers covered the treatment for mental health differently than the treatment for other physical conditions. The framework made insurance coverage for mental health higher, more restrictive as it has limits on the number of inpatient days and outpatient visits allowed, separate annual and lifetime caps on average, and a different authorization structure framework from other medical care plans (Goodell, 2014). These differences substantially affected the access and availability of mental care services primarily to vulnerable and underserved communities. The issue affects all individuals facing mental health challenges. The National Alliance on Mental Illness (2019) reports that 19.1% of U.S. adults experienced mental illness in 2018 (47.6 million people) which represents 1 in 5 adults. Further, 4.6% of U.S. adults experienced severe mental illness in 2018 (11.4 million people) which represents 1 in 25 adults (NAMI, 2019). Among the youth, 1 in 6 aged 6-17 experience mental health challenges each year, and suicide remains the second leading cause of death among people aged 10-34 years (NAMI, 2019). The issues of mental health parity occur nationally and continue to affect more people and bar them from adequate care. First efforts to address the issue were made in the Mental Health Parity Act passed in 1996. The act established guidelines for large employer-sponsored group plans and removed limits on mental health benefits (Horgan et al., 2015). However, the act did not mandate coverage for mental health treatment or remove treatment limits, disparities in cost-sharing or managed care efforts, making it less effective in addressing the issue. To address this, some states made more changes to the Act to move towards more parity. In 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA) was passed to address the gaps in the initial Act and include more groups of people. The Act ascertained the coverage of large group health plans, fully and self-insured and had a cost exemption (Horgan et al., 2015). Furthermore, the Act proscribed treatment limits, cost-sharing, and in and out of network coverage and included the treatment of substance use disorders. The Affordable Care Act (ACA) mandated the application of the law and parity by making it illegal to deny insurance coverage to people with pre-existing conditions within mental illness. Problem Statement Despite having the MHPAEA in place, Peterson, & Busch, (2018) note that consistency lacks in oversight and enforcement on the part of federal and state regulators. The disparities in implementation at the state levels remain a significant factor as they lead to health disparities between states and negatively affect parity (Bartlett, & Manderscheid, 2016; Peterson, & Busch, (2018). Further, the barriers of insurer non-quantitative treatment limitations still exist leading to differences in utilization management, medical necessity, deductibles and co-pays different in medical care and mental care and limited behavioral health services (Barry, Goldman, & Huskamp, 2016; Frank, 2017; Mechanic, 2017). The cost implications are still high for behavioral health patients who rely on out of network providers compared to 6% of patients in medical care within the same setting (Mechanic, 2017). While progress has been made in mental health parity, challenges in oversight are significant, with disparities still existing in insurer non-quantitative treatment limitations as well as behavioral health services. Suggestions for addressing the health issue caused by the current policy While MHPAEA led to progressive advancement to parity, more has to be done to attain mental health parity. In this, the input of policymaker at the federal and state level is necessary for ensuring firmer enforcement, transparency requirements and implementation of existing laws on parity (Barry, Goldman, & Huskamp, 2016; Mechanic, 2017; NAMI, 2019). One of the critical approaches begins with the definition of ‘medical necessity’ at the state level. The definition has to factor in clinical practice and use a behavioral health treatment model (Bobbitt, & Rockswold, 2016; NAMI, 2019). Secondly, the federal and state governments should train and equip mental health parity navigators to identify and detect parity violations and ensure compliance among insurers. Besides, public health agencies should establish programs and policies on the education of parity, insurance plans and mental health (Berry, Huskamp, Goldman, Rutkow, & Barry, 2017). More awareness will promote more effective mental health parity. Initiating policy change The policy change is required to accommodate the suggestions and move towards mental health parity. The need can be tied down to a focus on behavioral health services and oversight frameworks and led by the state and supported by federal efforts. The state public health team will have the mandate of gathering information in coordination with HHS and mental health organizations such as NAMI and Substance Abuse and Mental Health Services Administration (SAMHSA). The team should then draft the policy changes, and involve insurers and care providers on the policy changes. Upon changes or modifications to the draft policy, the final policy will be approved. Procedures supporting the process such as the development of training programs to support oversight and enforcement of MHPAEA and the proposed changes. The final stage will be implementation and monitoring to ensure useful application at the state level. 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Impact on the health care delivery system The proposed changes will have a significant effect on the ability of individuals to access mental health services. The changes will improve mental health coverage by facilitating the ease and costs of mental health care. Studies on the effective implementation of MHPAEA notes that greater access to physicians resulted in a change from physician mental health providers to cost-effective nonphysician providers (Huskamp, & Iglehart, 2016). Further, more focus will shift to the behavioral health system with masters-level specialists becoming the primary providers within the mental health continuum.   References APHA. (2019). Mental Health. Retrieved 21 December 2019, from https://www.apha.org/topics-and-issues/mental-health Barry, C. L., Goldman, H. H., & Huskamp, H. A. (2016). Federal parity in the evolving mental health and addiction care landscape. Health Affairs, 35(6), 1009-1016. Bartlett, J., & Manderscheid, R. (2016). What does mental health parity really mean for the care of people with serious mental illness? Psychiatric Clinics, 39(2), 331-342. Berry, K. N., Huskamp, H. A., Goldman, H. H., Rutkow, L., & Barry, C. L. (2017). Litigation provides clues to ongoing challenges in implementing insurance parity. Journal of health politics, policy and law, 42(6), 1065-1098. Bobbitt, B. L., & Rockswold, E. (2016). Behavioral health service delivery, managed care, and accountable care organizations. Encyclopedia of Mental Health, 150-155. Horgan, C. M., Hodgkin, D., Stewart, M. T., Quinn, A., Merrick, E. L., Reif, S., & Creedon, T. B. (2015). Health plans’ early response to federal parity legislation for mental health and addiction services. Psychiatric Services, 67(2), 162-168. Huskamp, H. A., & Iglehart, J. K. (2016). Mental health and substance-use reforms—milestones reached, challenges ahead. N Engl J Med, 375(7), 688-95. Mechanic, D. (2017). Coming Problems in Behavioral Health Care. The Milbank Quarterly, 95(2), 233. NAMI. (2019). Mental Health by the Numbers. NAMI: National Alliance on Mental Illness. Retrieved 21 December 2019, from https://www.nami.org/learn-more/mental-health-by-the-numbers Peterson, E., & Busch, S. (2018). Achieving mental health and substance use disorder treatment parity: a quarter century of policy making and research. Annual review of public health, 39, 421-435.

Question/  Paper Details

The benchmark assesses the following competencies:

 Participate in health care policy development to influence nursing practice and health care. Research public health issues on the \”Climate Change\” or \”Topics and Issues\” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population. Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue. Follow this outline when writing the policy brief:

1. Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources.
2. Create a problem statement.
3. Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.
4. Discuss the impact on the health care delivery system.

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Include three peer-reviewed sources and two other sources to support the policy brief. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

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