Bill Overview
Title: Increasing Mental Health Options Act of 2022
Description: 2022 This bill provides for an additional payment for clinical psychologists under Medicare who provide services in designated health professional shortage areas. It also allows clinical psychologists to provide behavioral health services (in accordance with state law) for purposes of hospitalization services, home health services, and other services under Medicare.
Sponsors: Sen. Brown, Sherrod [D-OH]
Target Audience
Population: Global population with potential access to improved mental health options through changes in healthcare systems like Medicare and equivalent programs.
Estimated Size: 63000000
- The bill aims to improve mental health service delivery through Medicare.
- This includes increased payments to clinical psychologists working in designated shortage areas, impacting their practice and services offered.
- Medicare beneficiaries, who typically include the elderly and disabled individuals, will be directly influenced as they may have increased access to mental health services.
- By allowing clinical psychologists greater roles in delivering behavioral health services, more patients might receive necessary mental health support, impacting their wellbeing positively.
- Beneficiaries located specifically in designated health professional shortage areas are particularly targeted as they traditionally have access issues.
Reasoning
- The primary target population for this policy includes Medicare beneficiaries, typically older adults and certain younger individuals with disabilities.
- The policy focuses on increasing access to mental health services in designated health professional shortage areas, which are prevalent in rural and underserved urban areas.
- The budget constraints will limit the extent and intensity of the service improvements, impacting areas differently based on their starting level of service deficiencies.
- Medicare beneficiaries in health professional shortage areas might experience a significant positive impact, as previously they had limited access to mental health professionals.
- Individuals living outside of these shortage areas may see little to no impact.
- The impact will vary based on the severity of each individual's mental health needs and their ability to utilize the increased services.
Simulated Interviews
retired teacher (rural Texas)
Age: 67 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- I have struggled to find a psychologist nearby who accepts Medicare.
- The lack of local mental health services has been a strain on my wellbeing.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
retired engineer (Chicago)
Age: 72 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- I already have good access to mental health care.
- This policy doesn't affect me much.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
part-time librarian (central California)
Age: 55 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- I'm not eligible for Medicare so this policy doesn't impact me.
- I wish there were more affordable options for my age group.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
retired mechanic (Albuquerque)
Age: 70 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 6/20
Statement of Opinion:
- Access to more psychologists would be a relief.
- This policy could really make a difference for people like me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 3 |
retired nurse (New York City)
Age: 75 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- I already have easy access to care in the city.
- My options won't be much different but could help others who aren't as fortunate.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
retired farmer (rural Alabama)
Age: 65 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 20.0 years
Commonness: 4/20
Statement of Opinion:
- There are no local mental health providers for someone like me.
- This policy could bring critical services to my community.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 7 | 3 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 3 |
retired school administrator (Miami)
Age: 82 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 11/20
Statement of Opinion:
- I have always had access to good mental health services.
- This policy might help underserved areas, not much change for me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
retired miner (remote Nevada)
Age: 68 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 12.0 years
Commonness: 3/20
Statement of Opinion:
- Increasing the amount of care available here would be a huge support.
- Currently, I struggle to find any specialists nearby.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 4 |
retired bank teller (Los Angeles suburbs)
Age: 61 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 14/20
Statement of Opinion:
- I've always had reasonable access to therapists.
- This policy likely won't affect me directly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
retired postal worker (Phoenix)
Age: 66 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 9/20
Statement of Opinion:
- There's a bit of a shortage in the area for specialists.
- Any improvement would be welcomed for those of us needing regular help.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
Cost Estimates
Year 1: $750000000 (Low: $500000000, High: $1000000000)
Year 2: $800000000 (Low: $520000000, High: $1050000000)
Year 3: $850000000 (Low: $540000000, High: $1100000000)
Year 5: $900000000 (Low: $580000000, High: $1150000000)
Year 10: $1000000000 (Low: $650000000, High: $1300000000)
Year 100: $13000000000 (Low: $8000000000, High: $18000000000)
Key Considerations
- Implementing these changes might require regulatory adaptations and training for clinical psychologists to expand their Medicare billing abilities, impacting the initial cost estimation for the government.
- The policy could exacerbate Medicare's longer-term financial sustainability challenges if cost controls are not integrated over time.
- Potential reduction in costs associated with untreated mental health conditions provides a qualitative argument for the policy, but quantifying such savings is challenging.