Increased electronic health record (EHR) use among behavioral health providers may encourage the integration of physical and behavioral health, suggests a report issued in January by the Bipartisan Policy Center (BPC).
BPC, a Washington, D.C.-based think tank, seeks to create policy solutions to some of the country’s more significant challenges, including those affecting the healthcare industry. The report, “Integrating Clinical and Mental Health: Challenges and Opportunities,” examined how the current U.S. health system separates physical and behavioral health.
By encouraging or requiring mental health providers to use EHRs, policymakers could promote the integration of physical and behavioral healthcare. The authors point out, however, that the report lists policy options as “a starting point for discussion,” not as an official statement from BPC.
Why Health Integration is Important
Providers and payers are becoming more focused on value-based care, which emphasizes improved patient outcomes. However, many different factors may be at play in an individual’s health.
Because of this, health providers often need to get a broader picture of their patient’s status and behaviors. Often this involves better care coordination and information exchange with the patient’s other health providers, including therapists, primary-care providers, and other specialists.
This is where EHR becomes more important. Use of EHR solutions makes it easier for behavioral health and addiction treatment providers to share patient information. This helps each provider get a better picture of the whole patient, their needs, and their health goals and progress.
Barriers to Behavioral Health Integration
The BPC report found three general barriers to the integration of physical and behavioral health:
1. Insurance Coverage of Behavioral Health: Public and private insurance plans offer different coverage of clinical health and mental health services, and often do not offer mental health parity.
2. Behavioral Health Workforce: The shortage of behavioral health and addiction treatment providers restricts access to behavioral and mental health services, which holds back integration.
3. Federal Administration: Government behavioral health agencies and programs have many overlapping responsibilities and services. This lack of coordination or a strategic plan to address these issues has also hindered integration.
How to Improve Behavioral Health Integration
This third barrier, involving federal administration, is where the increased use of EHR can be most effective. Expanded EHR use among behavioral health and addiction treatment providers can encourage information sharing. This can close coverage gaps and reduce redundancies.
BPC’s report notes out that the Health Information Technology for Economic and Clinical Health Act (HITECH), under the American Recovery and Reinvestment Act of 2009, encouraged the use of EHRs among medical providers, but did not include behavioral health providers or substance use disorder treatment. If HITECH funding was made available to behavioral health and addiction treatment providers, this could encourage EHR adoption and the resulting benefits.
Behavioral Health EHR That Promotes Information Sharing
As more behavioral health and addiction treatment providers seek EHR solutions, they may find themselves overwhelmed by the many available options.
BestNotes’ EHR and CRM solutions are developed specifically for behavioral health and addiction treatment providers. The software features help you collaborate and exchange information with those who need it. Contact us today to learn more!
Behavioral health and addiction treatment providers have not adapted to value-based payment (VBP) models as rapidly as other specialties. One major reason is because value-based care focuses on patient outcomes, which are difficult to define and measure in behavioral health.
However, as regulators and payers emphasize VBP, behavioral health providers eventually will be expected to make the transition, as well.
What Behavioral Health Providers Should Focus on When Moving to Value-Based Care
While it is challenging to define value and outcomes in behavioral health, behavioral health and addiction treatment providers who attempt it can benefit from potentially higher reimbursement and improved patient outcomes.
Here are some areas to focus on as you seek to make the shift to value-based care in your practice.
Use of data analytics
Value-based care focuses more on patient outcomes than the amount of services provided, encouraging providers to do more with less. Entering, tracking, and analyzing patient data is vital for transitioning to a VBP model. Without the proper data and tools to use it, however, behavioral health providers may find few benefits from VBP.
Because behavioral health conditions and goals are more subjective than other health specialties, clinicians and therapists may not be sure about the kind of patient data to track. This data may include:
DSM-V and ICD-10 criteria
Admissions and discharges, including emergency departments
As value-based care expands, healthcare decision-makers are increasingly concerned about population health. This requires clinicians to focus on three main goals:
Maintaining patient health
Reducing patient health risks
Providing or coordinating appropriate patient care
Successful population health management combines patient data with health IT solutions. Behavioral health practices should have an electronic health record (EHR) system that lets them collect and analyze data so they can note and correct any care gaps within the patient population. This leads to better outcomes and cost savings.
Interoperability is the ability of different systems or software to communicate and exchange information. This way, behavioral health and addiction treatment providers can more easily share data with a patient’s other providers. This could lead to better coordination of care, more efficient treatment, and thus improved patient outcomes.
All of the previously mentioned factors doubtless will involve changes to a practice’s workflow, potentially impacting all staff members. Behavioral health and addiction treatment practices may adopt a new EHR system, change the way they follow up with patients, or train staff to collect additional patient information.
As your practice shifts to value-based care, all clinicians and managers should make sure your employees understand the purposes behind any changes you implement. This will improve staff buy-in and make transitions easier.
The right EHR solution for your behavioral health data needs
A 2018 Quest Diagnostics survey found that 57 percent of health plan executives agreed that clinicians do not have all the tools they need to succeed under VBP. The right EHR system is vital for behavioral health and addiction treatment providers looking to record and track patient data.
Enter and track patient information accurately with BestNotes, a behavioral health EHR solution built specifically for your practice’s needs. Contact us today to ask questions, learn more, or schedule a live demo.
If you’ve seen the term “interoperability” used in the healthcare space, you may wonder what it has to do with your behavioral health practice.
What is Interoperability?
In healthcare information technology (IT), “interoperability” is when different systems, software, or devices can communicate and share information. This lets providers exchange data easily, potentially improving care.
Interoperability may be used synonymously with health information exchange (HIE), a similar idea.
According to the Healthcare Information and Management Systems Society (HIMSS), there are four types of interoperability:
Foundational interoperability: This involves disparate systems establishing the necessary requirements for one system or application to exchange data with another. This does not necessarily mean that the receiving system can interpret the data.
Structural interoperability: This defines the format standards for data exchange, creating uniform movement of information without altering its clinical or operational purpose. The data exchanged between health IT systems can be interpreted at the data field level.
Semantic interoperability: This involves systems exchanging, interpreting, and using data. Patient information is exchanged among authorized parties in different health IT systems and products, improving healthcare delivery and safety.
Organizational interoperability: This includes the technical, policy, and organizational components of interoperability. This type promotes simple, secure, accurate, and timely data exchange between providers and provider organizations.
History of Health Data Interoperability
Interoperability has gained more attention in recent years, but health data sharing has been a concern since providers first began using computers.
First examples of interoperability
An early example of HIE and interoperability was the community health management information system. This included a centralized data repository with individual-level demographic, clinical, and eligibility information for specifically defined communities. Local agencies and payers used the data for assessment.
Next came the regional health information organization (RHIO). This neutral, third-party organization helps improve healthcare by streamlining data exchange between providers within a geographical area. However, competition between different RHIOs means that this form of HIE did not achieve true interoperability.
Interoperability in the American Recovery & Reinvestment Act of 2009
The last few decades saw a rise in U.S. healthcare costs and rapid advancements in health IT. This led to growing interest in interoperability and its inclusion in major healthcare laws.
The Health Information Technology for Economic & Clinical Health (HITECH) Act was part of the American Recovery & Reinvestment Act of 2009. HITECH allocated $19 billion for health IT, promoted EHR use, and requires some level of interoperability for EHRs to be eligible for incentive payments.
Medicare’s Promoting Interoperability Programs
In August 2018, the Centers for Medicare and Medicaid Services (CMS) posted the final rule on the 2019 Medicare Hospital Inpatient Prospective Payment System and Long-Term Acute Care Hospital Prospective Payment System.
The final rule is expected to encourage interoperability. CMS aims to reduce provider burdens and emphasize measures that require the exchange of health information between providers and patients.
Does your EHR promote interoperability?
As interoperability becomes more prominent, behavioral health providers should make it a goal when choosing and integrating their EHR system.
BestNotes offers EHR and CRM solutions tailored specifically for behavioral health and addiction treatment providers, with features that help you collaborate and exchange information with those who need it. Contact us today to learn more!
Stay tuned to the BestNotes blog for future posts unpacking the issue of interoperability!
Value-based payment (VBP) models are a break from the volume-based, fee-for-service models that have long been the norm in U.S. healthcare. Under VBP, healthcare purchasers and payers hold providers accountable for healthcare quality and costs.
Many states and organizations are testing VBP models that could be applied to behavioral health, but have not yet chosen a standard for widespread use.
What are some models for value-based payments?
Valence Health (now Evolent Health) issued a white paper in 2013 that illustrated several potential VBP models that health providers could adopt. These include:
Pay for Performance, which ties financial incentives to measured performance
Bundled Payment/Episode of Care, which provides a single negotiated payment for all services delivered for a specified procedure or condition
Patient Centered Medical Home, which establishes a team of health professionals that work together to coordinate a patient’s care, particularly those with chronic or complicated conditions
Shared Savings, which rewards providers for reducing total healthcare spending on their patients below a level set by the payer, giving the provider a portion of the savings
Shared Risk, under which the provider must cover part of the costs if they do not meet savings targets
Capitation Models, under which a provider organization receives a set payment per patient for specified medical services, requiring the provider to take on all insurance risk for the covered patient and services
Provider-Sponsored Health Plans, under which a provider network assumes all financial risk for insuring that patient population and collects the insurance premium directly from employers or individuals
What value-based payment models are being implemented now?
The Affordable Care Act of 2010 instituted the Hospital Value-based Purchasing Program and Hospital Readmission Reduction Program. These initiatives reward acute-care hospitals with incentive payments for the care they provide to Medicare patients. The Centers for Medicare & Medicaid Services also began to pay healthcare providers based on quality of care.
2019 will see full implementation of the Merit Based Incentive Payments System (MIPS), created under the Medicare Access and CHIP Reauthorization Act of 2015. MIPS was designed to improve health outcomes, tie payments to cost-effective care, and encourage the use of healthcare information. The system measures performance based on data reported in four areas: Quality, Improvement Activities, Promoting Interoperability, and Cost.
Currently, MIPS is intended only for providers who are billing Medicare Part B more than $10,000 in claims per year, and excludes social workers and other behavioral health providers.
However, behavioral health and addiction treatment providers should keep an eye out for further developments involving MIPS and other VBP programs, as they could indicate the future of VBP models for behavioral health.
Why is VBP a challenge for behavioral health?
While VBP is heavily reliant on data, many behavioral health providers do not use standardized metrics to measure patient outcomes. In behavioral health, patient goals and outcomes are often subjective and highly individualized.
Because data is so important in VBP, an appropriate EHR system is crucial for recording patient outcomes and population health management. Behavioral health and addiction treatment providers who are preparing to move to VBP models may want to consider adopting an EHR solution tailored for the unique needs of their specialty.
Contact us to learn more about BestNotes today!