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June 17, 2015

Blue Cross foundation calls for fresh behavioral health regs, policy

In an effort to advise state law and policymakers on needed updates in regulation and policy around behavioral health care policy, the Blue Cross Blue Shield of Massachusetts Foundation has released a report highlighting the weaknesses of the behavior health system and how they might be fixed.

Prepared by consulting firm Bailit Health Purchasing with input from 20 Bay State provider organizations, the report highlights as top priorities:

-Fixing payment policies around integrating behavioral health services with other medical services;

-Developing a universal provider consent form to streamline the consent process among all types of providers, and

-Integrating medical records between mental health and physical health providers in the interest of communication about patients’ medical history.

‘Broad recognition’ of mind-body connection?

According to Audrey Shelto, president of the foundation, the impetus of the report dates back to last fall, when the foundation began to identify major priorities within the state’s Medicaid program, MassHealth, that the incoming Baker administration should focus on. Shelto said integration of the behavioral health care system with other medical services was among the top five areas in need of attention.

But it’s not just MassHealth that needs to rework policies around managing behavioral health services, which includes mental health and substance abuse services. Shelto said many of the same issues pertain to private insurers.

This also comes at a time when there are many state and federal initiatives aimed at integrating behavioral health services with other medical services, Shelto noted.

“There’s definitely very broad recognition now that issues of physical health and mental health … are very, very related (to) the best care in treating the whole person,” Shelto said in an interview with Central Mass Health Care.

A lack of behavioral health services integration may play out in a number of ways that make it complicated for providers to treat patients and for patients to receive services.

For example, the report cites the fact that separate licenses are needed from the Department of Public Health (DPH) to provide behavioral health services and regular medical services. That means a primary care office that would like to offer behavioral health services must apply for a different license, which Shelto said is a “cumbersome process.” Licenses are also subject to review every two years.

A blueprint for change

Meanwhile, if a patient shows up in a primary care office and appears to need mental health services, the doctor may not be able to send him or her to the counselor down the hall immediately because, according to Shelto, many insurers do not cover multiple services in one day.

Now, Shelto said she hopes the report will serve as a blueprint for legislators and policymakers to make short- and long-term changes that would improve how behavioral health services are delivered.

“We aren’t separated above the neck and below the neck,” Shelto said. “We really have to look at the whole person.”

Image source: Freedigitalphotos.net

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