By Nathaniel Z. Counts, J.D.
In 2019, a major study found that getting the right care can make pregnant individuals less likely to develop postpartum depression. The government now recommends that medical providers offer services, such as Mothers and Babies, to address early warning signs, and most types of health insurance now cover them. The new coverage could be game-changing for families in the U.S. – postpartum depression has huge consequences for birthing individuals and their children, and the chance to reduce the burden could help millions.
Unfortunately, there is still a long road ahead before people can actually access these prevention services. Changing medical practice is expensive, and most providers weren’t trained on how to do prevention. Thus, providers will need financial support to enhance the kinds of care they provide.
In a study recently published in JAMA Network Open, Mental Health America (MHA) and its research partners examined one way of helping providers get financial support to pay for prevention. We tested how much Medicaid would pay if it shared with providers half of the savings it expects over five years from preventing postpartum depression. In this scenario, providers would have to show that they reduced the total number of postpartum depression cases. We found that, under the right conditions, a payment approach like this could offer hundreds of dollars per person and add up to quite a lot – enough to provide strong financial support for preventing postpartum depression.
However, a few Medicaid-related issues stand in the way. First, people frequently change their insurance coverage, such as switching between Medicaid plans. When people switch, the insurance plan that paid upfront for prevention doesn’t get to enjoy all of the savings. Similarly, not all states have made sure that people can stay consistently covered on Medicaid. These issues make prevention harder to pay for because there is less savings for the Medicaid insurer to share with providers.
As states and the federal government come up with plans to pay for mental health and substance use care in new ways, MHA is working to tackle Medicaid-related matters and make postpartum preventive care part of the future. With our approach, providers could get the financial support they need to provide prevention services, and millions of pregnant individuals in the U.S. would get desperately needed better support.
Nathaniel Z. Counts, J.D., is senior vice president of behavioral health innovation at Mental Health America.