CMS Data Shows Decline in Mental Health Service Utilization Despite Reported Increase in Behavioral Health Conditions

Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries utilized mental health services 22% and 34% less, respectively, in 2020 when compared to the previous year, according to a new Centers for Medicare & Medicaid Services (CMS) report.

“Although utilization rates for some treatments have rebounded to pre-pandemic levels, mental health services show the slowest rebound,” said CMS in a press release. “The gap in service utilization due to the [public health emergency], particularly for mental health services, may have a substantial impact on long-term health outcomes.”

Adults aged 19 to 64 years used 12 million (22%) fewer mental health services and 3.6 million (13%) fewer substance use disorders services between April and October 2020. CHIP beneficiaries used approximately 14 million fewer mental health services. Utilization appears to keep declining despite evidence suggesting that more adults are reporting adverse mental health conditions throughout the pandemic.

The report also compared COVID-19 treatment and utilization of various other services through October 2020 using the CMS’s Transformed Medicaid Statistical Information System Analytic Files, which gathers data from providers, managed care agencies, and pharmacy benefit managers monthly.

In addition to decreased mental health service utilization, the data also indicated a 9% (1.8 million) decline in vaccinations for children up to age two, 21% (4.6 million) fewer child screening services, and 39% (11.4 million) fewer dental services.

Telehealth screenings, however, have seen a 2700% increase between 2019 and 2020, with the largest increases among adults aged 19 to 64 years and children aged 18 years and under.

Over 1.2 million Medicaid and CHIP beneficiaries received COVID-19 treatment and 124,000 were hospitalized through October. Additionally, Medicaid and CHIP paid for more than 9.9 million COVID-19 testing services during the period of study.

The report noted that services covered by Medicare were not included in results, so data may not reflect the full scope of COVID-19 treatments where beneficiaries were dually eligible.

“More than 100 million Americans, including 43 million children, relied on us to deliver access to mental health and other services they needed through Medicaid and CHIP in 2020,” said CMS Acting Administrator Liz Richter. “While we’re encouraged that people are accessing some health care services at pre-pandemic levels, there is work to do to connect people to mental health care services and to ensure we fill the gap in other types of services that was caused by the pandemic.”

—Maria Asimopoulos

References:

1. Centers for Medicare & Medicaid Services. Fact sheet: Medicaid & CHIP and the COVID-19 public health emergency [news release]. May 14, 2021. Accessed May 17, 2021. https://www.cms.gov/newsroom/fact-sheets/fact-sheet-medicaid-chip-and-covid-19-public-health-emergency
2. Centers for Medicare & Medicaid Services. CMS data shows vulnerable Americans forgoing mental health care during COVID-19 pandemic [news release]. May 14, 2021. Accessed May 17, 2021. https://www.cms.gov/newsroom/press-releases/cms-data-shows-vulnerable-americans-forgoing-mental-health-care-during-covid-19-pandemic