Is it time to reclassify Psychiatry as a Primary Care Specialty?

Milliman, Inc. has published an independent report analyzing the disparities in care for mental health and substance abuse problems versus the care for medical/physical problems. The report highlights that along with payment disparities, which occur in 46 out of 50 states, “out-of-network” use of mental health and substance abuse treatment providers by consumers is extremely high when compared to physical health care providers.

Unfortunately, many insurers are unable to maintain adequate networks of psychiatrists for patients, which partially stems from the fact that they reimburse psychiatrists substantially less than primary care physicians for the same services. The result is an unequal health care system for patients with mental illness or substance use disorders.

Realigning the reimbursement disparities though will not fix the problem, as the shortage of psychiatrists (and other mental health providers) is only likely to increase. Conceptually moving forward, Collaborative Care and similar models show promise. Innovative approaches such as those developed by Quartet Health are what is needed to address the real need.

BUT, it begs the question if whether the integration of primary care and behavioral health would be bolstered by simply reclassifying Psychiatry as a Primary Care Specialty.

Accessing Behavioral Health through Primary Care