Aetna applauds legislation on mental health coverage

For more than a decade, Congress has wrestled with how best to provide parity in healthcare coverage for mental health and substance-use conditions. Until recently it looked like another two-year session of Congress would come and go without passage of mental health parity legislation.

Now, we are at an important crossroads as the House and Senate have reached agreement on a workable solution supported by medical professionals, consumer advocates, hospitals, employers, health plans and other stakeholders.

This landmark agreement puts Congress in the position to finally write into law important changes to our healthcare system that have been a long time coming, and to help deliver improved benefits to mental health patients throughout the country.

Significantly, this legislative accomplishment also deserves credit for another important feature: By bringing together all stakeholders, by encouraging the exchange of ideas, by pushing those involved to understand real-world consequences of legislative action, and by finally reaching compromise, this effort provides an excellent roadmap of how well-meaning individuals and groups can accomplish meaningful healthcare reform.

This bodes well for efforts in the coming years, showing us a roadmap to reform and the inclusive process through which it can be achieved. The agreed-upon legislation establishes parity by requiring the same cost sharing and treatment parameters for mental healthcare services as for medical healthcare services. For example, under the legislation a patient would make the same co-payment to see a psychiatrist as he or she would pay to see a medical specialist.

Notably, this bill also would allow health plans to continue to provide innovative behavioral health services, avoid burdening employers with unnecessary costs and extend payment parity across the country, covering 82 million consumers not currently subject to state insurance rules.

This new legislation understands that patients should have confidence that they are receiving the best care possible based on the latest medical evidence available. As new medical evidence emerges about the most effective treatment options, health plans are helping physicians integrate these treatments into practice through a variety of medical management and care coordination tools.

These programs and services play a vital role in helping patients navigate through the complex and ever-changing healthcare delivery system. As the behavioral health field advances — with the development of transitional care settings, the growing role of the primary care physician, and the emergence of multiple new treatment options — there is a greater need for coordination of behavioral health care services.

For example, Aetna’s medical psychiatric case management program (which is designed to support patients with co-occurring medical and behavioral health disorders) has led to a 10 percent increase in depression screening and improved adherence to the prescribed treatment while also increasing access to psychiatric care by an impressive 20 percent.

Not only has this program improved the quality of care being delivered, it also has led to a reduction in overall medical costs for program enrollees, ensuring that patients are receiving the best value for their healthcare dollars. It is critical that we integrate physical and behavioral health, and ensuring mental health parity is an essential step toward reaching this goal.

The bill agreed to by the House and Senate leaders on this issue helps achieve this goal. For example, the bill does not limit plans’ ability to utilize the care coordination and management tools that are advancing high-quality, evidence-based mental health care. These are the tools needed to control costs without jeopardizing quality — the very tools currently used in the Federal Employees Health Benefit Plan (the plan used by Congress).

Statistics show that one in five Americans will suffer from a mental illness this year. With limited resources and costs continuing to be a major concern for purchasers, it is important that any mental health parity legislation be focused on providing better access to quality care for mental health and substance-use conditions. It is now time for the Congress to act by passing this landmark bill in 2008 and set the stage for continuing cooperation on health care issues in the future.

Williams is Aetna’s chairman and CEO, and Un is Aetna’s national medical director for behavioral health.