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Parity: Impacts to Mental Health and Addiction Providers

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Topics: Mental Health | Parity | Providers | Substance Abuse

This Advocates for Human Potential report provides an overview of the recently passed parity legislation and looks at "impact zones" for providers, the public, and policy makers.

From the report:

In the broadest sense, behavioral healthcare providers can expect the following impacts in their practices:

1. Requirements to enter into agreements with MBHOs or other forms of managed care.

2. Requirements to participate in more rigorous professional credentialing.

3. Requirements to participate in utilization management (pre‐certification or service and benefit authorization).

4. Increased use of diagnostic and screening tools to substantiate diagnoses.

5. Increased use of decision‐support and treatment planning tools that help plan and track treatment across longer episodes of care.

6. Expanded communication and collaboration with other healthcare providers such as primary care physicians.

7. Requirements to demonstrate that care is consistent with evidence‐based (scientificallyvalidated) best and promising practices.

8. Incentives to take advantage of enhanced insurance coverage by developing new levels of services, new services for co‐morbid or co‐occurring disorders, expanded geographic coverage, and relationships with primary care clinics.

9. Incentives to develop disease management programs and services for those with serious mental illness and various chronic conditions.

10. Incentives to assure timely, accurate and efficient health information. Consideration of electronic medical records systems for the purpose of care coordination, safety (especially in medications), and billing will come to the fore in practices that previously have only contemplated systems and technology adoption.

11. Increased need for expanded billing capacity and revenue generation, bearing in mind that ICD‐9 is giving way to ICD‐10 and that plans will differ in terms of what diagnoses are covered. For providers in some markets the result may be an array of coverage and contracts of even greater complexity than exists today.

12. Increased need for data management that generates outcomes data and enables quality improvement and financial analysis.

13. Increased collaboration with utilization management (usually Masters‐level behavioral healthcare professionals) in treatment planning.

14. Expanded awareness that new funding will stimulate competition for new resources.

Full Report: Behavioral Health Parity: Mental Health and Addiction Providers Impact Statement & Call to Actionexit disclaimer small icon

Advocates for Human Potential. (2008). Behavioral health parity: mental health and addiction providers impact statement & call to action. Gauthier, Patrick, Bianco, Carol, Shifman, Neal.


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