Mental Health Ghost Networks, Medicare Advantage Coops, & 340B Virtue Theater

Hey all,

Finding an in-network therapist is about as easy as finding a unicorn who takes insurance. The Department of Labor’s January report on the lack of mental health parity was unsurprising to say the least. Enjoy the rundown.

Jacob Brody (Co-Founder & CEO, ZorroRX)

(Employer Coverage) Federal Report Reveals Ongoing Gaps in Mental Health Coverage

Despite multiple federal laws mandating mental health parity, a recent Department of Labor (DOL) report reveals that many health plans still fail to meet these requirements. Between 2021 and 2023, enforcement actions impacted 72,000 plans covering 7.6 million members, yet access to mental health services remains significantly worse than for medical-surgical care. A “secret shopper” study found that only 8-28% of in-network mental health providers could offer an appointment within 30 days, compared to 24-37% for medical providers. Full Article

(HEALTH CARE un-covered) How Rural Electric Co-ops Could Transform Medicare Advantage

Dave Chase explores how the cooperative model—successfully used to electrify rural America—could offer a radical, bipartisan solution to fix Medicare Advantage. While Medicare Advantage has the flexibility to invest in social determinants of health, corporate takeovers have turned it into a profit-driven system that restricts care and increases denials. Chase argues that locally governed Medicare Advantage cooperatives, similar to rural electric co-ops, could re-center healthcare around communities rather than Wall Street. With historical examples like Alaska’s Nuka Health system and lessons from past cooperative attempts, he calls for policies that empower communities to reclaim healthcare sovereignty. Full Article.

(Linkedin) Chris Deacon on Ascension and 340B 

Chris Deacon criticizes Ascension, the nation’s largest Catholic health system, for publicly advocating congressional protection of its 340B drug pricing program profits despite its vast financial resources. She highlights how Ascension is divesting from hospitals in lower-income areas while expanding in wealthier markets, undermining its claims that 340B savings support vulnerable patients. Deacon also questions the health system’s financial priorities, pointing to its private equity investments, hospital closures, and even sports sponsorships. Lawmakers have scrutinized Ascension’s financial practices, raising concerns about whether it should continue to qualify for 340B benefits. Full Post