A Hybrid Funding and Coverage Model to Ensure Universal Access to Mobile Crisis Services
Patricia Boozang, Sabrina Corlette, Ashley Traube, and JoAnn Volk, Manatt Health and Georgetown University’s Center on Health Insurance Reforms
COVID-19, the resulting behavioral health crisis (including those related to mental health and substance use disorders), and calls for law enforcement reform related to behavioral health crisis response have heightened the urgency among federal, state, and local policymakers to expand access to behavioral health crisis services. Recently, the federal government has provided new funding opportunities to states to improve access to behavioral health crisis services, including mobile crisis services. The American Rescue Plan Act of 2021 (ARP) gives states the option of covering community mobile crisis intervention services in Medicaid for five years beginning in April 2022 (see here for additional information on the ARP mobile crisis option).
As states review the opportunities available to begin, enhance, or expand mobile crisis intervention services under ARP, policymakers may further consider a hybrid funding model that provides mobile crisis providers with a consistent and steady stream of funding to ensure they are able to maintain 24/7 availability and respond in a timely manner to all individuals in crisis, regardless of insurance status. Such a new model for funding mobile crisis services could also be designed to hold payers accountable for covering mobile crisis services when their enrolled members use this essential resource. This issue brief presents a sustainable, hybrid coverage and funding approach for mobile crisis services where mobile crisis providers would obtain:
A set amount or base funding that allows them to maintain continuous coverage; and
Third-party insurance reimbursement for services rendered to commercially covered individuals and Medicaid
enrollees.
On April 26, the U.S. Department of Health and Human Services Office for Civil Rights released a final rule interpreting section 1557 of the Affordable Care Act , which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability. This expert perspective reviews the implications of the rule for state policymakers.
As states continue to explore new ways to reach Medicaid and Marketplace members with targeted messages and updates about their coverage, many have incorporated SMS text messaging into their communications plans. This expert perspective highlights strategies and recommendations for states that are considering or currently implementing text messaging in their outreach plans to support states as they look to optimize text messaging in their Medicaid and Marketplace communications and outreach efforts.
The healthcare affordability crisis has resulted in an estimated 100 million Americans, or 41% of adults, holding some form of medical debt. The consequences of medical debt are profound, from financial strain to worsened health outcomes, and there are significant health equity implications. States are moving to eradicate medical debt for low income residents and protect residents from the financial consequences. This expert perspective highlights state action to cancel medical debt and/or prohibit medical debt reporting.