It is quite possibly the best of times in behavioral health, according to Linda Rosenberg, president and CEO of the National Council for Behavioral Health. A national parity law came on the scene in 2008, the Affordable Care Act passed in 2010, and subsequent gains in coverage and access have added up to an unprecedented opportunity in the business of treatment and recovery.
The National Council this year is placing an emphasis on the interface between hospitals and community organizations because the relationship is changing within the context of the big picture of healthcare, Rosenberg says. And in response, the two stakeholder groups must make fundamental shifts.
“We’re seeing healthcare as a commodity in ways we’ve never seen before, and that includes mental health and addiction,” she says. “The field is about growth.”
Hospitals now need behavioral health capabilities
Increasingly, hospitals need to become a more integral part of the extended provider community as they adopt accountable care models, whole-person health and outcomes-based strategies for their patients. Their livelihood now depends more and more on what happens outside of the hospital walls.
“With accountable care organizations, they are responsible for a population in a way that they’re almost the insurance company,” Rosenberg says.
Accountable care ties payment to outcomes, so risk is shifting in such a manner that the providers must share in the responsibility of being good stewards of the healthcare dollar. It’s no longer just the payers that are looking at prioritizing value over volume.
And with a clear need for mental health and substance use disorder services in the United States, accountability for whole-person health will translate to hospital systems seeking new capabilities and behavioral expertise.
Meanwhile, Medicare is looking at accountability as a means of reducing inpatient readmissions. Typically, when Medicare begins a wholesale program, the rest of the industry tends to follow the trend, so providers of all types are going to be involved in finding readmission solutions. It’s yet another way that hospitals are going to rely on their community provider partners in behavioral health, Rosenberg says.
“Hospitals are get fiscally punished for readmissions within certain timeframes so the relationship with community organizations and hospitals is changing,” she says. “Hospitals understand the need to be in community.”
She believes the hospital trends are relevant for behavioral health organizations because mental health and substance abuse treatment providers will ultimately face three options:
1 Remain independent but partner with existing health systems to coordinate care;
2 Become part of an existing hospital health system in one way or another; or
3 Compete with the health system as it develops its own in-house behavioral health services.
Rosenberg says this year’s National Council for Behavioral Health Conference in Orlando in April has a number of opportunities to discuss the current and future relationship between hospitals and community organizations.
“It’s a new arena we are seeing coming into the field, and the conference is going to reflect that issue,” she says.
While state hospitals were the norm for behavioral health in the early 1900s, followed by institutionalization and the advent of the specialty sector by the middle of century, she says the next “major wave” is integration that will break the specialty out of its silo and create new vocabulary among providers that work together.
Rosenberg says the National Council will focus on such growth opportunities at the conference through various tracks meant to educate new professionals, managers and seasoned executives, including a genius bar, workshops, sessions, live theater and networking opportunities. Special presentations will also examine new research on evidence-based treatment for first episode psychosis emerging from the National Institute of Mental Health.
“It’s a kickoff for new things in the field as well as culmination of what’s gone on over the past year,” she says. “There are many opportunities to summarize what’s happening and put our educated guess on where we going.”
The National Council for Behavioral Health Conference takes place in Orlando April 19 to 22. Find out more here
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