IMPROVING
THE LIVES
OF PEOPLE WITH MENTAL HEALTH
AND SUBSTANCE USE CONDITIONS
NEWS
LATEST RELEASE
Report from RTI International examining out-of-network use and reimbursement disparities between medical/surgical providers and behavioral health providers:
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Press Release – New Study Finds Continuing Pervasive Disparities in Access to In-Network Mental Health and Substance Use Disorder Treatment
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Report – Behavioral Health Parity – Pervasive Disparities in Access to In-Network Care Continue
Media Contact:
Cary Conway
972-649-4707
IMPROVING BEHAVIORAL HEALTH
ACCESS AND EQUITY
The Bowman Family Foundation ("BFF") conducts most of its activities regarding mental health and substance use ("MH/SU") conditions through its tax-exempt subsidiary the Mental Health Treatment and Research Institute LLC ("MHTARI").
The following tools and material, funded by MHTARI or other organizations, are intended to assist employers, third party administrators, regulatory agencies, accreditation organizations and others in (i) assessing access to care, quality of care and the cost of care, (ii) ensuring compliance with parity laws, and (iii) gaining awareness of evidence-based approaches that can improve access to, and the effectiveness of, behavioral healthcare while reducing total healthcare costs.
NETWORK ADEQUACY – ensuring access to in-network MH/SU providers
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Insurance Claims Data Analyses of Disparities:
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2024 RTI Report, entitled: Behavioral Health Parity – Pervasive Disparities in Access to In-Network Care Continue
Press Release – New Study Finds Continuing Pervasive Disparities in Access to In-Network Mental Health and Substance Use Disorder Treatment
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2019 Updated and Expanded Milliman Disparities Research Report, entitled: Addiction and mental health vs. physical health: Widening disparities in network use and reimbursement; A deeper analytical dive and updated results through 2017 for 37 million employees and dependents
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2018 Differential Reimbursement of Psychiatric Services by Psychiatrists and Other Medical Providers by authors at RTI, Truven, and SAMHSA
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2020 Milliman High-Cost Report – Impact of behavioral health conditions on physical and total healthcare spending
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Mental Health Access and Parity Recommendations for Plan Sponsors – actions an employer can take to address in-network access to MH/SU care and parity compliance
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2023 Model Data Request Form (MDRF) (Updated) – quantitative data templates used by employers, employer coalitions, and other stakeholders in requesting targeted, quantitative data from third party administrators for assessment of access to in-network behavioral health services. The MDRF has been used as a source and template by multiple regulators. Note: Clicking this link will download a Word document to your computer, which contains embedded Excel files.
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Data from Surveys Regarding Access to MH/SU Care:
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Surveys of Patients and Providers:
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2023 Survey conducted by NORC – Equitable Access to Mental Health and Substance Use Care: An Urgent Need: Patient-experience survey conducted by NORC shows stark access barriers for mental health versus physical health and reviews several related studies by others
Press Release – New Patient Survey Shows Pervasive Disparities in Access Between Mental Health and Substance Use Versus Physical Health Care: Leading mental health and employer groups come together around health system solutions for the nation's "staggering public health challenge" in mental health
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Network Access and Adequacy – Summary of Published and Unpublished Research 2018-2023 of Susan H. Busch and Kelly A. Kyanko
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2022 Template Survey of Employees to Evaluate Access to In-Network MH/SU Care – a survey employers can use to learn about their employees' experiences seeking MH/SU care
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Surveys of Employers:
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2023 Voice of the Purchaser – survey of 220 employers by the National Alliance of Healthcare Purchaser Coalitions and the HR Policy Association
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2022 Kaiser Family Foundation – survey of 2,188 employers
PARITY LAW COMPLIANCE – Non-Quantitative Treatment Limitations ("NQTLs")
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2017 Six-Steps Parity Guide for NQTL Compliance – a detailed issue brief covering specific types of non-quantitative treatment limitations governed by the federal parity law and regulations, with detailed illustrations to assist issuers, regulators or others
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2021 UPDATED ISSUE BRIEF: State Regulators' Use of Required Quantitative Data Templates to Assess NQTL Parity Compliance – an issue brief identifying a number of quantitative templates (MDRF as source) that several state regulators are requiring as they assess NQTL parity compliance
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BFF Comments on MHPAEA Technical Release 2023 – note that the MDRF is referenced in Appendix A of the Technical Release
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2023 ISSUE BRIEF: Federal Parity Law (MHPAEA): NQTL of In-Network Reimbursement Rates: Non-Comparable Use of Factors of Provider Leverage a/k/a Bargaining Power and Workforce Shortages – an issue brief analyzing how some health insurance plans / carriers define and use the factors of provider leverage and workforce shortages non-comparably and more stringently to support lower in-network reimbursement rates for MH/SU providers as compared to M/S providers
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2019 Best Practice Examples for NQTL Compliance with Regulatory Guidance Embedded – a set of examples for regulators and others, illustrating compliant design, application and comparability testing of non-quantitative treatment limitations
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2018-2021 Excerpts from Issue Briefs on Parity Compliance and Behavioral Health Network Adequacy Published by National Alliance of Healthcare Purchaser Coalitions
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2022 Model Hold Harmless Language – sample indemnification/hold harmless clause for use by employers in their vendor contracts with third party administrators, related to parity law compliance
THE COLLABORATIVE CARE MODEL ("CoCM") – the gold-standard approach to improving MH/SU clinical outcomes when MH/SU care is provided in primary care settings…where most people receive their MH/SU care
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Limitations of "Treatment as Usual" for Mental Health and Substance Use in Primary Care 2002-2021 – why broadscale implementation of CoCM is critical in order to improve MH/SU care
TELE-BEHAVIORAL CARE
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2020 Tele-behavioral Health Brief, entitled: Tele-Behavioral Health for Employees: Pre-COVID Practices and Recommendations for a Post COVID Path Forward – an examination of tele-behavioral health in the United States pre COVID-19, recent changes in policies and practices in response to this pandemic, and the opportunity tele-behavioral health presents to improve access to care
MEASUREMENT-BASED CARE ("MBC")
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2022 TPA Letters to Accreditation Agencies Regarding Measurement-based Care – letters employers can ask their TPAs to send to the 4 leading accreditation agencies, urging that Measurement-based Care be a requirement for accreditation
IMPROVING APPS FOR
MENTAL HEALTH AND SUBSTANCE USE
BFF has sought to advance access to and the quality of digital mental health tools.
MHTARI was a founding sponsor of the Society for Digital Mental Health.
MHTARI was the leading funder of Digital Tools and Solutions for Mental Health, a guide prepared jointly by the Northeast Business Group on Health and PsyberGuide.
MHTARI funded Reimbursement of Apps for Mental Health: Findings from Interviews.
ABOUT
MISSION
The Bowman Family Foundation (“BFF”) is a private foundation qualifying as a 501(c)(3) nonprofit organization. The primary mission of BFF is to improve the lives of people with mental health and substance use ("MH/SU") conditions. BFF also provides funding to support the education and welfare of children.
BFF is the Managing Member of the Mental Health Treatment and Research Institute LLC (“MHTARI”), a tax-exempt subsidiary of BFF which conducts most BFF activities regarding MH/SU conditions.
MHTARI provides funding to support projects, reports and the development of materials and tools related to:
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Improving health equity – e.g., access to MH/SU treatment for people who receive inadequate or no care due to financial or other barriers
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Improving the effectiveness and availability of digital health "apps" intended to help people with MH/SU conditions
BFF and MHTARI do not, themselves, provide or evaluate treatments or conduct clinical trials.
MANAGEMENT
Matthias B. Bowman, MBA
Mr. Bowman is President of The Bowman Family Foundation and is a member of the Steering Committee of the Path Forward for Mental Health and Substance Use. He was formerly a member of the Board of Directors of the Brain & Behavior Research Foundation, the American Cancer Society Foundation, the Sylvan C. Herman Foundation and One Mind.
Mr. Bowman was Vice Chairman of Investment Banking at Merrill Lynch and also Chief Executive Officer of Merrill Lynch Ventures and other private equity funds. After leaving Merrill Lynch, he was a founder of Fieldpoint Private Bank & Trust, RCT Logic (a clinical trial design company) and Ignition Interfaces (a software development company).
He also previously served on the Boards of Borg-Warner Automotive, Del Monte Foods, U.S. Foodservice, Active Health Management, Definity Health, MedAvante, Supermarkets General Corporation, and Teleport Communications Group.
Mr. Bowman graduated summa cum laude from Williams College with a degree in economics, and as a Baker Scholar from Harvard Business School. Subsequently, he studied molecular biology, neuroscience and biostatistics.
ADVISORS
BFF frequently retains organizations such as RTI, Milliman, and NORC to undertake specific projects.
In addition, BFF regularly receives advice from:
Henry T. Harbin, MD
Dr. Harbin is a psychiatrist with over 40 years of experience in the behavioral health field. He has held a number of senior positions in both public and private health care organizations. He worked for 10 years in the public mental health system in Maryland during the 1980s, serving as Director of the state mental health authority for three of those years. Between 1994 and 2004, Dr. Harbin was CEO or Chairman of two national behavioral healthcare companies – Greenspring Health Services and Magellan Health Services. In 2002, Dr. Harbin served on President Bush’s New Freedom Commission on Mental Health. In 2004, Dr. Harbin served as co-chair of the National Business Group on Health’s work group that produced the Employer’s Guide to Behavioral Health Services. Since 2004, Dr. Harbin has provided health care consulting services to a number of private and public organizations. More recently, he has been an adviser to the Path Forward for Mental Health and Substance Use and several private non-profit and for-profit organizations. He is on the Board of the Mental Health Association of Maryland, Brain Futures, and the Meadows Mental Health Policy Institute. Dr. Harbin co-authored The “Six Step” Parity Compliance Guide for Non-Quantitative Treatment Limitation (NQTL) Requirements (Sept. 2017) and The Bowman Family Foundation Model Data Request Form (MDRF). He has worked closely with federal regulators since 2009 and has been a subject matter expert consultant with several state Departments of Insurance since 2019 in the enforcement of the federal and state parity laws.
Beth Ann Middlebrook, JD
Beth Ann Middlebrook is a health lawyer specializing in behavioral health law and the owner of B. Middlebrook Consulting, LLC. Ms. Middlebrook’s subject matter expertise includes the Mental Health Parity and Addiction Equity Act (MHPAEA), state parity laws, as well as behavioral health network access and adequacy. She has been an attorney since 1987, practicing as both an associate and partner at private law firms in various specialties until transitioning to health law in 2006. Ms. Middlebrook worked for over 13 years with large behavioral health facilities in Florida and Texas, focusing on MHPAEA, state parity laws, state health insurance-related legislation and commercial behavioral health insurance coverage and reimbursements. She served on the executive committee of the Parity Implementation Coalition from 2010-2015 and was its co-chair in 2016. Ms. Middlebrook was Managing Editor of the Parity Resource Guide for Addiction & Mental Health Consumers, Providers and Advocates (Winter 2015), and co-authored The “Six Step” Parity Compliance Guide for Non-Quantitative Treatment Limitation (NQTL) Requirements (Sept. 2017) and The Bowman Family Foundation Model Data Request Form (MDRF). She chaired the ABA’s Health Law Section Interest Group on Mental Health and Substance Use Disorders from 2013-2016 and chaired its Advisory Board from 2017-2020. She has worked closely with federal regulators since 2009 and has been a subject matter expert consultant with several state Departments of Insurance in the enforcement of the federal and state parity laws.
Brenda Jackson, MPP
Brenda Jackson specializes in policy, program design and implementation and regulatory analysis for Medicaid and Children’s Health Insurance Programs (CHIP) with a focus on delivery system innovation, value-based purchasing (VBP), Federally Qualified Health Centers, intellectual and developmental disability (I/DD) and behavioral health system redesigns and Centers for Medicare & Medicaid Services (CMS) policy compliance. Having worked in this field since 1993, Brenda focused on home and community-based services (HCBS), behavioral health, and managed care policy when she was employed by CMS, the State of Kansas, Mercer Government Human Resources Consulting, and Deloitte & Touche Management Consulting. While employed by CMS, Brenda was the Iowa State Representative for three years, and reviewed all Iowa waivers and amendments. Brenda currently advises several behavioral health organizations such as The Bowman Family Foundation, Healthy Minds, and Meadows Mental Health Policy Institute. Brenda was a contributing author for MHSUD Issue Briefs for the Meadows Mental Health Policy Institute identifying key billing codes for Coordinated Specialty Care (First Episode Psychosis) and Behavioral Health Crisis services and the use of these codes to support parity in reimbursement.
Michael Yuhas, MA
Mr. Yuhas brings to The Bowman Family Foundation more than three decades of experience working with healthcare start-ups, Behavioral Health Management & Integration, Community Health Work, Social Determinants of Health, Medicaid/Medicare/Dual Eligible populations and healthcare analytics. He founded Integra ServiceConnect, a first-to-market company specializing in engaging high-need individuals in their own communities - identifying and addressing social needs that adversely impact their health, and connecting them with needed healthcare and related services. Mr. Yuhas previously served as CEO of Health Integrated, a FL-based integrated care management company, and held a number of executive leadership roles in Magellan Health Services. He holds a masters degree in Clinical/Community Psychology from Temple University and completed additional graduate training in Psychiatric Epidemiology at The Johns Hopkins Bloomberg School of Public Health. In addition to the Bowman Family Foundation, Mr. Yuhas serves as an advisor to other private and nonprofit organizations, including the Mental Health Treatment and Research Institute, the Mental Health Association of Maryland, the Path Forward for Mental Health and Substance Use, firsthand, Brain Futures and Tiatros.
Lisa Wells
Ms. Wells serves as BFF/MHTARI's Senior Analyst. She brings to the foundation several years of data analysis and quality improvement experience in the mental health and substance use field and has co-authored multiple BFF/MHTARI publications.
CONTACT
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