Preparing for Parity and Health Care Reform

As the landmark parity legislation takes effect this year and we look forward to the increased access to health care coverage that will take effect in 2014 due to the recently passed health reform legislation, NIATx is working to develop tools to help service providers use process improvement and systems design to improve their back office functions as well as their work with clients.

Parity and health reform will increase the number of people who seek treatment and have insurance to cover it. One part of the health reform bill that takes place this year is the requirement for health plans to allow adult children to stay on their parent's insurance until age 27. This expansion of coverage to young adults means that many people that need treatment now have coverage. That coverage requires the capacity to bill for service. The capacity to bill for services may mean a change in staff, both clinical and office staff; it may mean the need to develop a process for billing or for paying more attention to collections as insurance reimbursement may become a bigger portion of your revenues.

As the health care payment system becomes more responsible for paying for services, the health care delivery system will become more responsible for delivering services. Already we see widening use of SBIR and a large proportion of community health centers already have behavioral health specialists who are providing mental health counseling but will soon develop capacity for adding addiction treatment to their mix. What this means for specialty providers is the need to develop relationships with health care providers now.

It may be time to begin thinking about integrated electronic health record systems that can communicate with other local health systems and can offer both a clinical record and practice management services. An important aspect of health reform is to modernize the health care delivery system through these kinds of systems and a great deal of money is available to help providers purchase and integrate these systems into their practice. Right now you are mostly excluded from access to the funds, but there are several efforts underway that should change that in the near future.

All of these changes will have a huge impact on the behavioral health and particularly the addiction treatment business model. NIATx is developing a set of tools and training opportunities to help you make the transition from your current business model to the business practice of the future. The first two projects are already underway. We have the NIATx Billing Guide, published for those who have never had to bill for services and want a place to start. We also have a fifty site learning collaborative that will launch in October to help providers develop or improve upon their billing practices. In October, we will also launch a collaborative project with the National Association of Community Health Centers to better integrate behavioral and community health programs.

Keep reading our blog and checking the web site for more opportunities to participate in efforts to move business practices forward.

And always remember to keep your customer/client in mind. In the end, we hope that these changes will expand access to services to an extent that we couldn't achieve by just improving agency efficiency. Together, we will move forward to ensure that everyone that needs treatment can get it!

Kim Johnson
Co-Deputy Director, NIATx