Accelerating the Transformation of Behavioral Health Care Delivery

Earlier in September, CipherHealth joined other thought leaders at the CMS Innovation Center Behavioral Health Payment and Care Delivery Innovation Summit in Baltimore. Major challenges around providing and reimbursing behavioral health care were explored, including those around substance use disorders, mental health and co-occurring conditions.

Background

An estimated 20.8 million people in the United States are living with a substance use disorder, a chronic relapsing disease with personal, economic, and public health consequences. This is comparable to the prevalence of diabetes and more than 1.5 times the number of people living with all cancers combined. Last year, more than 50,000 Americans died from drug overdoses and the death rates from prescription Opioid overdoses alone have quadrupled in the past fifteen years. Faced with such a large and growing epidemic, our health care system must focus on achieving a coordinated, outcomes-driven approach to substance use disorder prevention and treatment.

The Need for Transformation

Creating recovery-oriented systems of care requires a transformation of the entire service system as it shifts to becoming responsive to meet the needs of individuals and families seeking services. Three main transformation focus areas requiring standardized assessments, care coordination, and outcomes monitoring include:

  1. Providing comprehensive and coordinated treatment that includes, medical, psychological, and social services
  2. Shifting from volume to value through measurement-based care, and enhancing population reporting capabilities, and improving quality assurance and reporting infrastructure
  3. Integrating health systems with addiction treatment and increasing access to services where there is coordination across acute, and non-acute and SUD specialty and non-SUD specialty settings

Prioritizing Mental Health and Substance Use Disorders

Addressing mental health and substance use disorders is clearly a national priority, with numerous states having selected “individuals with serious mental illness and/or Substance Use Disorders” as the primary chronic condition to address under Section 2703 of the Affordable Care Act.

As a behavioral health thought partner dedicated to improving patient outcomes, CipherHealth understands the need to address substance use disorders and mental health conditions. We are further dedicated to providing solutions that help providers overcome the many challenges of achieving an effective behavioral healthcare system.

In the second part of this blog series, we will expand on the role of technology in addressing the challenges of transformation.

Elizabeth Lagone, MPH, is the Vice President of Government Programs at CipherHealth. Prior to her current role at CipherHealth, Lagone served as the Primary Care Strategy and Improvement Director for DSRIP Initiatives at One City Health, a subsidiary of NYC Health + Hospitals focused on population health, care management, and implementation of the state’s DSRIP program.