With the final rules on "meaningful use," standards and certification criteria and the temporary electronic health record certification program all released, many health care providers are starting to scramble to ensure that they can qualify for Medicare and Medicaid incentive payments beginning in 2011. But there's one sector of the health care industry that you won't find reading up on the recent rules or comparing EHR products from different vendors.
The 2009 federal economic stimulus package excludes clinical psychologists, clinical social workers, psychiatric hospitals, mental health treatment facilities and substance abuse treatment facilities from receiving incentive payments for the meaningful use of EHRs.
Exclusion of Mental Health Providers
Charles Ingoglia -- vice president of public policy at the National Council for Community Behavioral Health Care -- said that while psychiatrists and nurse practitioners who provide mental health and addiction services at community behavioral health organizations are eligible for health IT incentive payments, all other health care providers within CBHOs are not. He added that "while hospitals can receive facility payments under the Medicare and Medicaid incentive programs, CBHOs are excluded from receiving facility payments."
Ingoglia said, "As the Recovery Act was developed in Congress, the amount of money available for health information technology was reduced from $50 billion to $20 billion, leaving congressional staff with the task of prioritizing providers and entities." He added, "Understanding that the meaningful use of health IT was necessary for health care reform to succeed, hospitals and primary care providers were named as eligible for these new incentive payments."
According to Ingoglia, lawmakers recognize the need to expand eligibility for the incentive payments.
Benefits of Health IT in Mental Health Care
Mental health advocates say that greater use of health IT could improve mental health outcomes by improving care coordination and quality of care.
"People with mental health and substance abuse conditions are in desperate need for more coordinated, integrated health care," Linda Rosenberg, president and CEO of the National Council, said in a press release, adding, "Having an interoperable system of electronic health information is critical to achieving greater coordination among addiction, mental health and other health care providers and to helping consumers manage their own health care."
Ingoglia noted that 2006 Substance Abuse and Mental Health Services Administration study found disproportionate morbidity and premature death among patients treated in the public health system. The study found that such patients died in their earlier fifties, primarily due to preventable medical conditions, he said.
"Adequate funding for technology is critical to enabling mental health and addiction providers to implement systems that help them provide quality care, measure outcomes and enable continuity of care between primary care, mental health and addiction services," Ingoglia said. He added that without health IT adoption, community behavioral health providers cannot track health outcomes, engage in cost-effective chronic disease prevention and recovery or be held accountable for using best practices.
Legislation To Expand Incentive Payment Eligibility
In April, Reps. Patrick Kennedy (D-R.I.) and Tim Murphy (R-Pa.) introduced the Health Information Technology Extension for Behavioral Health Services Act of 2010 (HR 5040) to extend incentive payments included in the HITECH Act to the mental and behavioral health community.
"Delivering health IT to mental and behavioral providers bridges the care for those with mental and physical illnesses," Murphy, a psychologist, said in a press release. He added, "To best diagnose and treat patients, mental health professionals need complete, up-to-date medical histories. ... Electronic medical records ensure that physicians and mental health professionals are working together and delivering the best possible treatments."
Rep. Gene Green (D-Texas), a co-sponsor of the bill, said, "As a long-time supporter of access to mental health services, I'm glad to see this legislation as a corrective action to a previous oversight. The vague language in the HITECH Act was insufficient to allow the equal access of mental health facilities to health IT grants." He added, "These mental health facilities should have the same access as other hospitals and providers, and with the passage of this legislation, they will."
Ingoglia said there are not any groups that oppose HR 5040. He said, "In fact, there is widespread support from the mental health and addiction community, as well as from health IT interest groups."
Status of Legislation
The National Council and other groups are actively lobbying for the passage of Kennedy and Murphy's bill, and the National Council has announced a goal to enlist 100 co-sponsors for the bill. As of last week, HR 5040 has attracted the support from 61 House lawmakers.
Despite the bipartisan support, the legislation has been in the House Committee on Energy and Commerce and the Committee on Ways and Means since April.
Ingoglia said, "With the August recess looming, it is unclear how much floor time is available for new legislation." He added, "The National Council and our partners will continue to seek avenues to move this legislation and to build support for the underlying issues for equity that are fundamental to this proposal."