黑料正能量 Note: Some of the brightest leaders in behavioral health policy, program, and innovation weigh in from across the country to share their thoughts on opportunities and challenges in 2015. This may read like a road-map of the year to come. Where do you fit in to the process of overcoming the hurdles and seizing opportunities?
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Readers Open Up About Challenges They Expect to Face in 2015
We asked our readers to send us their thoughts on the challenges and 听opportunities听 听awaiting the 听field 听in
2015. 听Here are 听some 听of their 听comments we received.
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Ron听听 听Manderscheid,听 听Ph.D., executive 听director, National As- sociation 听of 听County听 听Behavioral Health 听& Developmental Disability听听 听Directors听 听(NACBHDD)/National 听Association for Rural Mental Health (NARMH),Washington, D.C.
We do expect 听2015 to be a year of great challenges, 听as well as wonderful 听opportunities. 听On 听the 听challenge side, we hope 听that we will influence the Supreme Court to decide that the Affordable Care Act permits federal 听tax 听subsidies听听 when 听a 听state insurance 听exchange听 听is operated by HHS 听(U.S. 听Department 听of 听Health and Human 听Services). We hope 听that we will move beyond 听Rep. Tim Murphy 听(R-Penn.) 听and 听his 听contentious proposed legislation听 (Helping Families in Mental Health Crisis Act) to a much 听better 听bill that reflects all key voices in our field. Finally, we hope 听that 听we 听will make 听significant 听progress 听in 听developing and 听implementing听听 听medical听听 听homes听听 听and听听 听health homes.
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On听 听the听 听opportunity 听side,听 听we will address 听the tragedy of the incarceration听听 听of听 听persons听听 听with听 听mental health 听and substance use conditions 听in听 听county听 听and听 听city 听jails. 听We 听will make 听progress听 听to 听incorporate 听dis- ease 听prevention and 听health 听promotion听 听interventions听 听into听 听our听 听work, and听 听we听 听will 听reach听 听out听 听to 听public health听 colleagues 听to help us address 听community 听issues. 听Finally, 听we 听will continue听 听to 听expand听 听peer听 听support 听and听 听integrated听 听peer听 听support听 听very quickly. Clearly, we want the opportunities听 听in 听2015 听to听 听outweigh听 听the challenges, 听and we want to continue 听our听听 quest听 听toward听 听person-centered and 听whole 听health 听care 听at the 听rapid pace 听both deserve.
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Patrick听听听 听Gauthier,听 听director, AHP 听(Advocates for 听Human 听Potential听听 听Inc.)听听 听Healthcare听 听Solutions, Sudbury, Mass.
With health 听care reform now 听in full force, the behavioral 听health field faces听 听ongoing听听 听challenges听听 听around 听the 听enforcement 听of 听the 听parity 听law (particularly around 听coverage 听of residential 听treatment听 听services) 听and 听in relation 听to 听integration 听of behavioral 听health 听and 听medical 听health 听care 听鈥 not 听least 听because 听the 听trend 听toward behavioral 听health carve-outs 听continues.听 听Also,听 听providers听听 听struggle听听 听to maintain听 听revenue听 听cycles 听and 听cash flow 听under 听the 听collective 听pressures 听of听 听ICD-10听 听(10th听 听revision听 听of听 听the International 听Statistical听 听Classification 听of Diseases and 听Related Health Problems) 听implementation 听later 听in the听 听year,听 听the听 听cost听 听of 听technology implementations,听听 听and听听听 听increasing competition.
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Even more concerning for a truly 听integrated听 听care 听approach is 听the delayed听 听recognition听 听of 听the 听importance听听 听of听听 听social听 听determinants听 听of health. 听The need 听is growing 听for inclusion听 听of 听social 听and听 听community- 听based听 听services 听into 听integration听 听efforts.听 听On听听 听the听听 听other听听 听hand,听听 听the awareness and 听traction 听of 听population health management (PHM) concepts as a framework 听for integration 听offers tremendous potential 听for optimizing 听health. 听By focusing 听on 听specific 听populations鈥櫶 听needs,听 听PHM engages听 听clinicians,听 听activates听 听patients and 听families, 听and 听measures听 听quality and 听outcomes based 听on 听significant population听 听factors.听听 听Opportunities abound 听for 听behavioral听 听health 听providers 听to 听apply 听PHM principles听 听to such听 听efforts听 听as 听care听 听coordination where 听chronic 听comorbid 听conditions 听exist. Another significant opportunity for business 听growth 听is the formation 听of 听provider 听networks,听 听such 听as management 听service听 听organizations 听(MSOs) 听and听 听independent 听practice associations听 (IPAs), to maximize cost savings and new, profitable 听revenue 听streams.
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Steven 听Ronik, 听Ph.D., 听CEO, Henderson听 听Behavioral听 听Health, Fort Lauderdale, Fla.
I think 听2015 will see 听increased 听pressure听 听on 听behavioral听 听health 听systems听 听to听 听further听 听integrate听 听primary health 听care 听and听 听behavioral听 听health care.听 听The听 听evidence听 听is 听now听 听overwhelming听 听relative 听to 听the 听very 听real overall health and financial outcome 听improvements that result from a true and听 听deep听 听integration.听 听The 听鈥渢riple aim鈥 听of 听health听 听care听 听鈥斕 听improved 听health听听 听outcomes,听听 听decreased听 听cost and improved 听patient 听experience 鈥 will be the mantra. And don鈥檛 be surprised听 听to 听see 听鈥渢he 听patient听 听experience鈥 getting much 听of the attention. 听As competition increases 听and 听pay- for-outcomes 听becomes听听 听the听 听norm, providers 听and 听payors 听will continue 听to 听spend听 听enormous 听resources听 听and focus 听on听 听the 听鈥渢riple 听aim.鈥 听Finally, workforce 听and talent challenges 听will continue, 听and the best and most innovative organizations will direct increased 听capital 听on 听employee training, 听engagement 听and 听wellness. 听As always, leadership will mean 听everything and the most intentional 听organizations听 will thrive.
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Clarke听 听Ross,听 听D.P.A.,听 听public 听policy director, American 听Association听 听on 听Health听 听and 听Disability, Rockville, Md.
The general health care sector is moving听 听to听 听meaningfully听 听integrate behavioral听听听 听health听听听 听into听听听 听general health. The behavioral 听health field is meaningfully 听moving 听to 听bring 听general 听health听 听into 听behavioral听 听health settings. Trains are moving on separate 听tracks. However, 听interoperable, integrated听听听听 听and听听听听 听person-centered electronic听听 听health听听 听record听听 听systems generally 听do not include 听behavioral 听health.听听 听Also,听 听while听听 听the听听 听general health听 听care 听and听 听community-based disability听 听fields听 听are听 听implementing person-centered, whole听 health听 quality听 听measurement,听 听the听听 听behavioral 听health 听field is just now 听implementing medical-behavioral setting traditional treatment 听measurements. Can the behavioral 听health 听field catch听 up in听听 听integrated听听 听delivery,听听 听including electronic 听health 听records 听and meaningful 听nonclinical听 听community听 听support measurement? 听In 2015, will the behavioral听 听health听听 field 听move 听from hand 听carts to trains?
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Debra 听L. Wentz, 听Ph.D., CEO, New 听Jersey 听Association of 听Mental 听Health听 听and 听Addiction Agencies 听Inc., Trenton, N.J.
Hope 听is always 听on 听the 听horizon 听with the advent of a new year. What I find especially exciting is Congress鈥 focus on private-public partnerships to accelerate 听the discovery, development and delivery cycle in the United 听States 听to 听foster 听innovation听 听and bring 听new 听treatments 听and 听cures 听to children听 听and听 听adults听 听with听 听mental health 听and 听substance use 听disorders. Under 听the 听leadership 听of 听New 听Jersey鈥檚听 听own听 听Congressman听听 听Leonard Lance 听and听 听the听 听Energy 听and听 听Commerce 听Committee, 听New Jersey鈥檚 and the nation鈥檚 pharmaceutical and bio- medical 听industry 听and private 听corporations听 听are听 听partnering听 听to 听research听 the causes 听of schizophrenia and 听bi- polar 听disorder, 听as听 well 听as听 investing in听 听personalized听 听medicine,听听 听which also 听offers 听great 听potential 听for 听early intervention 听and 听for eliminating 听the trial-and-error 听approach by targeting subgroups 听for 听different听 听treatments 听based 听on genetics.
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While听 听passage听 听of 听the听 听Mental Health 听Parity and 听Addiction 听Equity Act (MHPAEA) was groundbreaking, there 听are 听limitations 听that behavioral 听health 听stakeholders find disappointing. The law does 听not mandate 听that insurance 听companies cover 听mental health 听and 听substance use 听treatment services. 听Rather, it only requires 听insurance 听plans 听that 听cover 听these 听services to do 听so with 听coverage 听limits and out-of-pocket expenses that are quantitatively and qualitatively equal as coverage 听for medical and surgical care. Despite this progress 听as well as that provided through 听the mandated parity coverage 听of mental health and substance 听use 听services 听of 听all those who听 fall under 听the Medicaid Expansion听 听and听 听the听 听Healthcare听听 听Market- place,听听听 how听 听comprehensively听 听the MHPAEA is implemented remains 听a challenge 听as insurers interpret 听medical necessity more narrowly than the recovery-oriented听 听and听听 听habilitative services听 听necessary听 听to听 听keep听 听those with 听mental听 听health听 听and 听substance use challenges 听well. In fact, in order to 听move听 听closer 听to 听the 听day 听when mental 听illnesses 听and 听substance use disorders 听are treated 听just like physical 听ailments 听鈥 听not 听only 听clinically, but 听also 听in 听attitude,听 听we 听still 听have mountains 听to climb 听鈥 but 听at least, we already are in the foothills!
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A positive sign is the greater focus 听on听 听mental听 听illnesses听 听and听 听substance 听use听 disorders 听鈥 in New Jersey, 听from 听Governor听 听Christie鈥檚 clear commitment to addiction 听prevention and听 听treatment听 听and听 听the听 听increased 听awareness of the illnesses, as well as suicide, 听following 听the 听death 听of 听actors 听Philip 听Seymour 听Hoffman 听and Robin 听Williams. The 听challenge 听will be to keep 听a sustained 听sense 听of urgency in providing 听adequate visibility for the 听issues, 听funding 听for 听treatment,听听听 听and听听听 听necessary听听听听 听services, including听听听 听housing,听听听 听employment, transportation 听and 听other听 听supports, without听 听a 听tragedy听 听such 听as 听opioid overdoses, school shootings or more suicides to propel 听the field forward.
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To call eliminating the barrier of stigma against individuals with mental 听and 听substance 听use 听disorders听 听a mere challenge 听is to understate how much public and political will it will take听 听to 听bring听 听funding听 听levels听 听and mind-sets 听to the point 听that these 听illnesses 听are regarded 听simply as other diseases. 听Given the high prevalence rates of behavioral health 听disorders, we 听will build 听on 听progress 听and 听demand 听fair rates 听and 听adequate treatment 听for services, housing, employment 听and 听other听 听supports听 听to 听keep our听 听providers听听 听fiscally 听healthy听 听so
they 听can 听serve 听children 听and 听adults with 听emotional 听and 听behavioral 听disorders and mental illnesses and substance 听use disorders 听well and 听in recovery in 2015 and beyond.
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Tom 听Doub, Ph.D., CEO, Centerstone听听听 听Research听听听 听Institute, Nashville, Tenn.
We are at the dawn 听of an exciting 听era 听in 听health听 听care. 听Given 听the convergence 听of 听innovative听 听mobile technologies with 听payment 听reforms in 听health听 听care听 听that听 听reward听 听better care 听and 听lower 听costs,听 we 听are 听likely to 听see 听more听 听innovation听 听in 听health care in the next five years than during any period 听in the last 50.
The Centerstone 听Research 听Institute听 听recently听 听hosted听 听a 听forum听 听on mental 听health 听and 听mobile 听technologies at the mHealth Summit in Washington, 听D.C. What 听is becoming 听apparent 听as 听we 听begin 听to 听use 听mobile technologies in 听health 听care 听is 听that the听听 听most听听 听important听听 听location听听 听in health 听care is no longer 听the doctor鈥檚 office, or even the hospital, but rather the home.
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This is being 听made 听possible 听by an explosion 听of new 听mobile 听phone, app听 听and听 听sensor听 听technologies 听that will enable 听you 听to connect 听to your health care providers 听just as easily as you might check in for a flight, order movie 听tickets, 听or 听even听听 use 听secure banking听 听online.听听 While 听health听 听care has long enjoyed 听sophisticated technology听听 听in听 听hospitals听听 听and听听 听clinics, health 听care 听is finally about 听to enter the 21st century in terms of consumer technology. This is great news for all of us, and a great opportunity for health 听care organizations 听and 听entrepreneurs to help invent that future. 鈥
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