The Affordable Care Act intended to improve the quality of healthcare in the U.S. while driving down costs. Millions qualified for Medicaid under the new guidelines, and millions more qualified for affordable insurance plans. Provisions were put into place about who received coverage and the type of care they could pay for with their new policies. Mental health was classified as an essential service, meaning it was guaranteed coverage under any insurance plan.
Insurance Policies Then and Now
Before the ACA, there were several ways patients were robbed of adequate mental and behavioral healthcare:
- Insurance companies rarely covered treatments.
- They often dropped patients with mental and behavioral problems.
- New insurance companies could deny care based on pre-existing conditions.
This left the nation’s most vulnerable populations without any access to healthcare. Low- and middle-income families struggled to pay out-of-pocket and often went without care. Legislation changed these struggles, but new rules for mental health billing under ObamaCare created new barriers. Companies were forced to provide mental health services, and they weren’t allowed to deny coverage to patients — even to individuals who were already diagnosed with conditions requiring expensive lifelong treatment.
In order to make up the difference, insurance companies began:
- Demanding higher co-pays and higher deductibles
- Introducing strict restrictions on covered care
- Shrinking reimbursements paid to professionals
However, they had to provide certain services, such as depression screening, without any out-of-pocket expenses.
Changes to Mental Healthcare Delivery
The Affordable Care Act’s impact on mental health billing options did not go as planned. Instead of opening up care for millions of new patients, many participants found their doctors wouldn’t accept their insurance. Providers simply couldn’t afford the training and software needed to learn the new billing systems. Others were crippled by slow payment processing or simply the low rate of reimbursement offered by many of the largest insurance companies.
Overall, what was the impact of ObamaCare on mental health providers? The industry has seen a serious shift in the way counselors, psychotherapists, psychiatrists and others care for patients. While practices used to be small, often located in the provider’s home, more of today’s mental and behavior health professionals are joining larger care groups. They’re joining forces with peers in general medicine and other specialties in order to provide their new pool of patients with the care they deserve. However, that is not the only choice available.
Considering Other Options
Mental health professionals have been hit especially hard because of the self-contained nature of many practices. It isn’t rare for a counselor to be both a care provider and an accounting department. With so many new regulations to learn about and so many different insurance companies to manage, the responsibilities under ACA can feel overwhelming. With the right support, it doesn’t have to be.
It’s surprising how ObamaCare changed mental health billing practices, and it’s inspiring to see the way some providers are morphing to meet their patients’ needs. Knowledgeable mental health billing specialists at BPS will help you maintain your profits while you continue providing care to new and established patients. Learn how your business can benefit today by contacting BPS for a free quote.