A recent study conducted by researchers from Washington University School of Medicine in St. Louis and the Yale School of Public Health has found that a nationwide Medicare program aimed at improving healthcare and reducing costs has not resulted in any improvements in mental health care. The program, known as accountable care organizations, was established under the Affordable Care Act and consists of networks of healthcare providers who work together to ensure comprehensive care for specific patient groups.
The study analyzed data from a representative sample of Medicare beneficiaries between 2016 and 2019 and compared the mental health outcomes of those enrolled in traditional fee-for-service programs with those participating in accountable care organizations. The researchers found no significant disparities in mental health outcomes between the two groups.
According to senior author Kenton Johnston from Washington University, accountable care organizations are currently the most important payment and care model in Medicare, but they have not shown any improvement in the treatment of depression and anxiety disorders, which are the most prevalent mental health conditions in society. The study also revealed that individuals with depression or anxiety were less likely to seek outpatient mental health care in accountable care organizations.
The study highlighted that accountable care organizations are compensated based on each patient’s medical complexity, regardless of the actual cost of care. They receive shared savings from Medicare when costs are contained and quality benchmarks are met, but they are also financially responsible when costs exceed projections. This financial incentive is intended to control costs while maintaining or improving quality of care.
Led by Jason M. Hockenberry from the Yale School of Public Health, the study analyzed de-identified data from the Medicare Current Beneficiary Survey. The findings showed that individuals who transitioned to an accountable care organization did not experience an increased likelihood of receiving mental health treatment or any discernible improvements in symptoms compared to those enrolled in regular Medicare.
While the study’s results suggest that accountable care organizations have had no effect on the quality of mental health care, Johnston hopes that the findings will encourage policymakers to consider more specific measures for mental health care quality. The Department of Health and Human Services recently released guidelines for mental health care, and Johnston believes that a more specific approach is necessary.
The study, published in the journal Health Affairs, raises important questions about the effectiveness of accountable care organizations in improving mental health care outcomes. Further research and policy changes may be needed to address these concerns and ensure that patients receive the best possible mental health care within these programs.
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