Mental health is big news in the NFL right now and Derek Carr of the Oakland Raiders is at its center. Carr allegedly cried on the sidelines during a recent game, causing a “fractured relationship” with his teammates who now lack confidence in his ability to lead the team (The Athletic). Sadly, Carr’s story is a microcosm of how mental health is viewed in America.
In my previous blog, Untreated Mental Illness and Its Consequences, I talked about the 4 steps (shown below) that employers can take to achieve positive effects by addressing mental health in the workplace (National Alliance of Healthcare Purchaser Coalitions brief).
As the Carr incident demonstrates, overcoming the negative stigmas associated with mental illness can be difficult. Are these perceived stigmas the reasons why knowing the impact of mental health and substance abuse on your population is not easy to discern? You may be asking yourself why evaluating mental health’s effects on your plan’s members can be so difficult?
It should be noted that protecting everyone’s privacy is an important goal for all Plan Sponsors. In light of this goal, Part 2 of HIPAA and other state regulations don’t allow plan sponsors to access and use substance abuse and mental health data without obtaining patient consent first. You can’t use these types of data like you use protected health information (PHI) data for treatment, payment, and plan operation functions. This hinders your ERISA imposed fiduciary duties to monitor the performance of your plans to ensure they are being run in the best interest of participants.
You should be concerned about this lack of access to mental health and/or substance abuse data. According to the IFEBP Workplace Wellness Trends 2017 Survey, depression/mental illness is the 7th leading condition driving employer healthcare costs.
Employers should be concerned about lack of access to mental health and/or substance abuse data. - Sashi Segu, Innovu Counsel
The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and ACA require qualified health plans to cover substance abuse and mental health as they do other medically recognized diseases like heart disease and diabetes. But that recognition is not happening, according to a 2017 Milliman study that focused on nonquantitative treatment limitations for:
As mentioned earlier, ERISA requires you to ensure your plans are being run in the best interest of participants. But if you don’t have access to those types of data; how can you:
You must have access to your mental health data and integrate it with your medical and pharmacy data to uncover the real issues and cost drivers in your population. To get data transparency, you need to create a framework that respects individual privacy, while also ensuring the efficacy of substance abuse and mental health services.
A potentially successful framework should include the following:
You must have access to your mental health data and integrate it with your medical and pharmacy data to uncover the real issues and cost drivers in your population. – Sashi Segu, Innovu Counsel
While you may not be able to enact change unilaterally, working collectively with other employers and interested parties may bring about change that permits better access to substance abuse and/or mental health services and data. There is strength in numbers. Business groups on health, industry trade associations, chambers of commerce, and other employer-related coalitions can take up this charge. Become an advocate for mental health transparency so you can use integrated data to control costs, improve quality, and most of all, improve health.