Report Finds Missouri Has Serious Shortfalls In Mental Health Care Access, Coverage

March 27, 2018 | By Chris Warner

A new report has found that the State of Missouri has serious gaps between mental health care needs and access to care.

For Kayla Dawson, her first bout with opioids and methamphetamines took her to the methadone clinic in Springfield.
Kayla Dawson: “You pay $125 a week, plus you have to, at the beginning, you have to drive up there everyday, so that’s gas money you have to drive everyday.”

She paid out of pocket for the clinic and kept going until she couldn’t afford it any longer.
Dawson: “That clinic, if that were free, or covered by insurance, I know it would just open the door for a lot more success stories.”

That’s where the issues come in.

The report highlights barriers between available services and insurance coverage – citing that many health insurance plans had extremely limited mental health providers.

According to the report, in Missouri in 2015, insurance claims filed showed that 14.6% of all behavioral health visits were out of network, while only 2.9% of primary care were out of network.

And the Missouri Federation believes that can be attributed to behavioral health providers opting out of health plans due to low reimbursement rates.

In 2015, primary care providers received reimbursements averaging 104.3% of allowed Medicare rate, while behavioral health providers only received 78.5% of that same Medicare rate.

The Lafayette House offers behavioral and some mental health services to women in need, and while they receive state assistance for some programs, they have to turn elsewhere for other funding.

Deb Allman, Layfayette House Clinical Director: “We utilize jasper county tax money and we have some other vendors, some other private grants that we write, as well as certainly donations and fund raising.”

Mental health organizations across the state are now calling on legislatures to pass House Bill 2384, which would increase fairness in health insurance coverage and require providers to cover mental health care at the same level as other physical health conditions, which Dawson hopes will go into effect.

Dawson: “Some people don’t realize how many people are addicted, and how many people need medication to assist and live everyday life.”

That bill will soon head to the senate.