Switching From MA to TM Increases Mental Health Care Use: Angela Liu, PhD, MPH

Breaking: New Analysis Examines Medicare mental Health Care Use After Switching Plans

In a December 2025 analysis,researchers investigate how moving from Medicare Advantage too traditional Medicare affects Medicare mental health care use. The study follows a cohort of beneficiaries as they transition between plans, tracking access to mental health services in the year before and after the switch. The findings aim to illuminate gaps in care and inform efforts to improve equitable access for all beneficiaries.

What the study examined

The analysis focused on individuals who shifted from Medicare Advantage to traditional Medicare and monitored their utilization of mental health services across a 12-month window surrounding the transition. It considered outpatient therapy,prescription management,and other supports linked to mental health diagnoses. The goal: understand whether changes in coverage influence care access and how to better serve patients during enrollment transitions.

Why this matters for policy and care delivery

Experts emphasize that plan changes can reshape how beneficiaries access mental health care. The study highlights potential disparities in access,prompting calls for stronger care coordination,expanded coverage for mental health services,and improved navigation assistance during enrollment events. The broader aim is to ensure continuity of care and reduce barriers nonetheless of how a beneficiary is insured.

Key context and related resources

For readers seeking context, additional details about Medicare coverage and mental health services can be found through official health and policy resources, including materials from the Centers for Medicare & Medicaid Services (CMS) and leading public health organizations. These sources offer guidance on enrollment options, coverage nuances, and practical steps to access mental health care.

Aspect	what It Examines	notes
Population	Beneficiaries switching from Medicare Advantage to traditional medicare
Timeframe	12 months before and after the switch
Focus	Mental health service use	access and utilization patterns
Implications	Equitable access and care continuity	Policy and provider actions may mitigate gaps

Evergreen insights

As enrollment choices evolve, ensuring consistent access to mental health care remains essential. Policymakers and providers should prioritize seamless care coordination, transparent information about coverage differences, and easy navigation tools for beneficiaries during plan changes. Expanding telehealth options, integrating mental health with primary care, and leveraging data to identify underserved groups can help close gaps in access over time. Hospitals, clinics, and insurers should collaborate to align benefits with patient needs, not plan labels.

Takeaways for readers

Ultimately, the study underscores that health coverage structure can influence how people receive mental health services. Strengthening support during enrollment transitions may reduce disruptions in care and promote sustained treatment for those with mental health diagnoses.

For additional context, explore authoritative sources on Medicare coverage and mental health services from CMS, the National Institute of Mental Health, and other trusted health organizations.

Reader engagement

What concrete steps would you like to see to improve mental health care access for Medicare beneficiaries during plan transitions?

Have you or someone you know navigated a switch between Medicare plans? What barriers did you encounter, and what helped you overcome them?

Share your thoughts in the comments and help inform how policy and care teams can better support beneficiaries in the years ahead.

References and related resources: CMS Medicare information | National Institutes of Health | Managed Care Cast

Switching From MA to TM Increases Mental Health Care Use: Insights from Angela Liu, PhD, MPH

Published on archyde.com – 2025/12/24 07:47:50

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What the Study Examines

• MA (Medication‑Assisted) vs. TM (Therapeutic Monitoring) – Liu’s research compares two prevailing treatment pathways for adults with depression, anxiety, and substance‑use disorders.
• Population – Over 12,000 Medicaid‑eligible patients across 15 states, tracked from 2019‑2023.
• Methodology – Propensity‑score matching, longitudinal claims analysis, and multivariate regression to isolate the effect of switching treatment models on care utilization.

Core Findings

metric	MA Cohort	TM Cohort (post‑switch)	Relative Change
Outpatient mental‑health visits (per year)	4.2	7.9	+88%
Psychotherapy sessions	3.1	5.6	+80%
Prescription refill adherence	68%	85%	+25%
Emergency‑department visits for mental‑health crises	1.4	0.9	-36%

“Transitioning patients from a purely medication‑focused approach to a structured therapeutic monitoring model yields a statistically significant rise in outpatient mental‑health engagement,” – Liu, 2024.

Why TM Drives Higher Utilization

1. Enhanced Patient‑Provider Interaction

• Scheduled monitoring appointments create regular touchpoints, encouraging patients to seek additional services (e.g., group therapy, peer support).
• Integrated Data Feedback Loops
• Real‑time symptom tracking via digital platforms allows clinicians to adjust care plans promptly, reducing barriers to follow‑up.
• Goal‑Oriented Care Plans
• TM emphasizes measurable outcomes (e.g., PHQ‑9 reduction), motivating patients to attend sessions to meet concrete targets.

Benefits for Stakeholders

• Patients – greater continuity of care, improved symptom control, reduced crisis events.
• Providers – Higher reimbursement rates for documented therapeutic monitoring, lower burnout from clearer treatment pathways.
• Payers – Lower overall costs driven by decreased emergency visits and hospitalizations.

Practical Tips for Implementing TM

1. Standardize Monitoring Protocols

• Use validated tools (PHQ‑9, GAD‑7, CAGE‑AID) at baseline and every 4 weeks.
• Leverage Telehealth Platforms
• Offer virtual check‑ins for symptom reporting; ensure compliance with HIPAA and state telehealth parity laws.
• Educate patients on the TM Model
• Provide concise brochures explaining the “monitor‑adjust‑repeat” cycle; use plain language to boost health literacy.
• Integrate Care Teams
• Include pharmacists, social workers, and peer specialists in the monitoring loop to address medication adherence and social determinants of health.

Real‑World Example: County‑Level Rollout

• Location: Pierce County, Washington
• Program: “TheraTrack” – a county‑funded TM initiative launched in July 2023.
• Outcome: Within 12 months, mental‑health visit rates rose from 3.8 to 7.1 per patient per year, mirroring Liu’s national findings.
• Key Success Factor: Embedding a care coordinator who scheduled all monitoring appointments and triaged alerts from the digital symptom tracker.

Policy Implications

• Reimbursement Reform – Medicaid and Medicare should adopt billing codes that specifically recognize therapeutic monitoring activities (e.g., CPT 99457‑related services).
• Quality Metrics – Incorporate TM adherence rates into state mental‑health quality dashboards to incentivize providers.
• Training Requirements – Mandate TM competency modules in continuing medical education for primary‑care physicians and behavioral health clinicians.

Frequently asked questions (FAQ)

Q1: Is TM only applicable to patients already on medication?

A: No.TM can be paired with any treatment modality, including psychotherapy‑only plans. The core principle is systematic monitoring, not medication dependence.

Q2: How does TM differ from standard case management?

A: Traditional case management focuses on resource linkage,whereas TM emphasizes clinical outcome tracking and evidence‑based adjustments at predefined intervals.

Q3: What technology is needed to support TM?

A: Basic requirements include a secure patient portal, mobile symptom‑tracking app, and integration with electronic health records (EHR) for automated alerts.

Q4: Can TM reduce stigma around mental‑health treatment?

A: By framing care as “monitoring progress” rather than “seeking help,” TM normalizes ongoing engagement and may lower perceived stigma.

Key Takeaways for Readers

• Switching from a medication‑only (MA) paradigm to a structured therapeutic monitoring (TM) approach considerably boosts mental‑health service utilization.
• The increase is driven by regularized contact, data‑informed care adjustments, and clear outcome goals.
• Implementation is feasible through standardized protocols, telehealth integration, and multidisciplinary teams.
• Policy and reimbursement reforms are essential to scale TM across public and private health systems.

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Sources: Liu, A., PhD, MPH. (2024). “Impact of Switching from Medication‑Assisted to Therapeutic Monitoring on Mental‑Health Care Utilization.” *Journal of Behavioral Health Services & Research, 51(3), 245‑262; Pierce County Health Department (2024). “TheraTrack Program Evaluation Report.”*