Skip to main content
Sister Publication Links
  • ESG: THE IMPLEMENTATION IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Digital Health
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Unwell in America
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Care Delivery
April 01, 2021 01:25 PM

Addressing long-standing barriers needed for mental and physical health integration

Steven Ross Johnson
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Getty Images

    The pandemic's negative impact on the mental health of millions of people has renewed discussions around why that nation's behavioral healthcare system has been inadequate to meet the level demand for care.

    But the failure to meet patients' mental health needs predated the pandemic. Approximately 43% of the more than 51 million adults estimated to have had a mental health condition in 2019 received treatment, according to care access data compiled by Mental Health America.

    The care gap has prompted calls for healthcare providers to move swiftly toward integrating behavioral healthcare services into primary care. Holistic approaches to physical and mental healthcare have been shown to help identify more patients experiencing a mental health issue and provide them with earlier interventions that can improve outcomes.

    But that transition has hit financial, labor, regulatory and technological roadblocks.

    "We have essentially set up two separate delivery systems," said Dr. Harold Pincus, professor and vice chair of the department of psychiatry and co-director of the Irving Institute for Clinical and Translational Research at Columbia University and the New York State Psychiatric Institute.

    Much of the problem comes down to how behavioral healthcare providers get paid, Pincus said. Low reimbursement has disincentivized behavioral healthcare professionals from participating in insurance networks, which has made it difficult for primary care to refer patients or consult with them on care plans, according to a Bipartisan Policy Center-commissioned report released Wednesday.

    Most providers still get reimbursed through a fee-for-service model that does not incentivize primary care practitioners to address behavioral health conditions, Pincus said. Also, the low rates of reimbursement for mental healthcare services has led to an increasing number of psychiatrists to not accept insurance. Only 55% of psychiatrists accepted commercial coverage compared to 88% among other medical specialties; 54% of psychiatrists accepted Medicare and 43% took Medicaid for payment.

    The BPC report called for regulatory changes that provided financial incentives for integrated care delivery under Medicaid and Medicare managed care plans as well as the creation of new capitated models to pay primary care professionals who provide behavioral healthcare services to patients with mild and moderate mental health issues.

    "It's a symptom of how broken the system has been and how difficult it is to coordinate that we're still trying to figure out these sort of baseline processes," said John Snook, director of government relations and strategic initiatives for the National Association for Behavioral Healthcare.

    A lack of on-the-ground coordination between medical and behavioral healthcare providers continues to be a major barrier to integration, a problem that has been compounded by shortages in the number of professionals available to meet the demand for services, Snook said. Nationally, more than 50% of U.S. counties do not have a licensed behavioral health provider, according to the Health Resources and Services Administration.

    The BPC task force recommended the federal government create a technical assistance program for primary care practices to receive the training on delivering integrated care. Other suggestions included expanding Medicare coverage to allow social workers to bill Medicare for chronic care management services.

    The report called for permanently removing some of the restrictions that limited the use of telehealth services prior to the pandemic. Over the past year, mental health was the leading health condition where telehealth was used, accounting for 44% of all visits.

    "Expanding telehealth access permanently would eliminate access disparities and address the digital divide," said former New Hampshire Gov. John Sununu, co-chair of the task force. "Telehealth will help treat far more people faster and in their own homes. Removing the telehealth video requirement would also enable those without broadband, video technology, or an understanding of how to use it, to access care from afar."

    But technological barriers to integration go beyond expanding telehealth. For years there has been limited information sharing between behavioral health and medical providers, with the majority of mental healthcare setting still lacking electronic health record systems with the capabilities to effectively integrate with hospital EHR platforms.

    BPC's report recommended Congress direct CMS to provide funding to help support the adoption of health information technology within behavioral healthcare settings.

    Overall, Snook said he was hopeful the report's recommendations would provide policy makers with a path toward addressing some of the longstanding issues that have kept providers from more robustly integrating behavioral and physical health.

    "That's the real opportunity that we have to seize," Snook said.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    crowd of people
    Facing an uncertain future, industry leaders get creative with care delivery
    988 illustration
    National 988 mental health hotline back up after widespread service outage
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Digital Health
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Unwell in America
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing