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Brief Reports
Published Online: 8 June 2023

Medicare Changes in Response to COVID-19: Unintended Effects for Beneficiaries With Mental Illness or Substance Use Disorders

Alexander D. McCourt, J.D., Ph.D. [email protected], Sarah A. White, M.S.P.H., Victoria R. Green, M.H.S., and Emma E. McGinty, Ph.D., M.S.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 74, Number 12
https://doi.org/10.1176/appi.ps.20220502
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Abstract

Objective:

The authors explored potential unintended consequences of Medicare policy changes in response to the COVID-19 pandemic for beneficiaries with behavioral health care needs.

Methods:

The authors collected policies relevant to mental health and substance use care. Informed by a literature review conducted in spring 2022, the authors convened a modified Delphi panel with 13 experts in June 2022. The authors assessed expert consensus through panelist surveys conducted before and after the panel convened.

Results:

Two policies that had a risk for unintended consequences for those with behavioral health care needs were identified. Panelists identified a discharge planning waiver as likely to decrease care access, care quality, and desirable outcomes and HIPAA enforcement discretion as likely to increase access to care and desirable outcomes (with some mixed effects on other outcomes) for Medicare beneficiaries with mental illness or substance use disorders.

Conclusions:

Policies implemented quickly during the pandemic did not always account for unintended consequences for beneficiaries with behavioral health care needs.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 74 • Number 12 • December 01, 2023
Pages: 1285 - 1288
PubMed: 37287226

History

Received: 30 September 2022
Revision received: 4 May 2023
Accepted: 15 May 2023
Published online: 8 June 2023
Published in print: December 01, 2023

Keywords

  1. Public policy issues
  2. COVID-19
  3. Mental illness
  4. Alcohol and drug use
  5. Medicare

Authors

Details

Alexander D. McCourt, J.D., Ph.D. [email protected]
Departments of Health Policy and Management (McCourt, White) and Mental Health (Green), Johns Hopkins Bloomberg School of Public Health, Baltimore; Department of Population Health Sciences, Division of Health Policy and Economics, Weill Cornell Medicine, New York City (McGinty).
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Sarah A. White, M.S.P.H.
Departments of Health Policy and Management (McCourt, White) and Mental Health (Green), Johns Hopkins Bloomberg School of Public Health, Baltimore; Department of Population Health Sciences, Division of Health Policy and Economics, Weill Cornell Medicine, New York City (McGinty).
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Victoria R. Green, M.H.S.
Departments of Health Policy and Management (McCourt, White) and Mental Health (Green), Johns Hopkins Bloomberg School of Public Health, Baltimore; Department of Population Health Sciences, Division of Health Policy and Economics, Weill Cornell Medicine, New York City (McGinty).
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Emma E. McGinty, Ph.D., M.S.
Departments of Health Policy and Management (McCourt, White) and Mental Health (Green), Johns Hopkins Bloomberg School of Public Health, Baltimore; Department of Population Health Sciences, Division of Health Policy and Economics, Weill Cornell Medicine, New York City (McGinty).
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Notes

Send correspondence to Dr. McCourt ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

This work was supported by a grant from the Commonwealth Fund.

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