Dive Brief:
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A 48-page report from the Bipartisan Policy Center highlights how payer, workforce and administrative barriers create silos between mental and medical health and offers potential solutions. The group offered suggestions for improving three areas with barriers: insurance coverage and payments, workforce and administrative problems.
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Among ideas to spur change: integration of financing, increased federal spending and improved care coordination to reduce duplication. The report also suggested a task force of stakeholders to "consider options and find consensus on recommendations."
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The paper examined how to improve integration of services after consulting with patient advocates, clinical and behavioral healthcare providers, officials, payers, academics and other experts.
Dive Insight:
With suicide and drug and alcohol use all on the rise, BPC said experts point to the need for early intervention to prevent serious mental health issues. Grant programs have helped improve mental health treatment and integrated care.
Despite those efforts, stand-alone mental health treatment centers maintain silos of care. Plus, health insurance coverage gaps and mental health professional shortages make "it difficult to promote federal policy that moves toward sustainable insurance-financed care and away from grant-financed care and siloed, stand-alone outpatient mental health services."
"The history and structure of the mental health system has resulted in payment and policy silos and a host of agencies and providers that, while committed to quality care for people with mental illness, have significant interest in changes to the status quo," according to the report.
These improvements include phasing out Medicaid carve-outs, establishing mental health parity in Medicare and Medicaid, reimbursing behavioral health telehealth services, promoting care integration in training, improving financial resources in high-need areas and pushing mental health providers to use EHRs.
Health systems and providers have increasingly turned to a collaborative care model as a way to improve care coordination. However, barriers between mental health and medical care remain, including reimbursement and structural issues.
To create a successful integrated system, Ben Miller, chief strategy officer at Well Being Trust, told Healthcare Dive last year that a payer needs to take the lead and pay behavioral health providers properly. That includes rewarding improved health outcomes and lower costs.
"It requires patience, the right partners, especially payer partners and community backing," Miller said. "Practices thinking they can just integrate may be in for a challenging lesson as many levers need to be pulled at once."