Kim Johnson, Deputy Director, NIATx
With Election Day fast approaching, healthcare reform is a
hot topic. Many believe the election results will determine the future of the
Affordable Care Act, which is designed to extend health insurance coverage to
more than 30 million Americans. Yet
regardless of who wins in November, behavioral healthcare providers need to
adapt to changes that are already taking place and are not likely to be
reversed.
The Mental Health Parity and Addiction Equity Act, passed in
2008, requires insurance plans that offer coverage for mental illness and
substance use disorders provide those benefits at the same level as medical and
surgical procedures. The Affordable Care Act will require all insurance plans to provide coverage for mental illness and
substance abuse disorders. Both pieces of legislation present behavioral health
providers with the option of billing third-party payers for the services they
provide—for some new sources of revenue to replace rapidly shrinking state and
federal grant funds.
While some states oppose making changes required to prepare
for the ACA, others are moving forward with Accountable Care Organizations and
Health Insurance Exchanges. Treatment organizations need to stay on top of
what’s happening in their states. Rather than “wait and see,” the best approach
may be build capacity to bill for services, because no matter who gets elected,
grant funds are not likely to increase.
States across the country have slashed funding, and we can’t
assume that the federal block grants for mental health and substance abuse
treatment are going to continue at their current level, especially with the
“fiscal cliff” of tax increases and spending cuts looming ahead of us at the
end of 2012 if Congress doesn’t act. It’s likely that we’ll see more cuts. Finding
other sources of revenue will be even more crucial.
Aside from healthcare reform, other forces are driving
change in the addiction treatment field. The Partnership at Drugfree.org
recently reported that visits to physicians
for substance use disorders, primarily opioid abuse, increased by 70%
between 2003 and 2009. With an increase in the awareness of addiction as a
treatable disease, more people will seek treatment from their primary care
providers. Specialty treatment programs need to consider partnering with these
providers, or addiction treatment may go the way of depression treatment–with
most people seeking medication, and counseling becoming an ancillary service.
The health reform ball has been rolling for some time now
for behavioral health providers. What happens in November may slow it down or
adjust its course, but not stop it.
Now’s the time to prepare.
