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Reimbursement of Mental Health Services in Primary Care Settings

Reimbursement of Mental Health Services in Primary Care Settings
Author: Donna Mauch
Publisher: DIANE Publishing
Total Pages: 60
Release: 2011-04
Genre: Health & Fitness
ISBN: 1437929281

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In 2005¿06 a study identified the barriers to, and solutions for RMHS. This study was divided into two parts. The first part is a White Paper background report which identifies the barriers to successful provision of RMHS. The second part convened a Expert Forum who reviewed the White Paper, and suggested actions to reduce those barriers. This Final Report incorporates their deliberations and addresses the following: Describes the purpose and rationale of the project; Outlines the project¿s tasks; Details findings from the White Paper; Summarizes the June 2006 Expert Forum discussion; and Provides suggested actions to the Fed. gov¿t. on steps to overcome existing or perceived barriers to RMHS. Illustrations. This is a print on demand report.


Reimbursement of Mental Health Services in Primary Care Settings

Reimbursement of Mental Health Services in Primary Care Settings
Author: U.S. Department of Health and Human Services
Publisher: Lulu.com
Total Pages: 60
Release: 2019-11-23
Genre: Reference
ISBN: 1794763562

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Implementing these practical and largely achievable suggestions will improve access to timely and targeted mental health services in primary care settings. Program and clinical experts agree that the early prevention and treatment of mental disorders will result in decreases in individual suffering, family burden, and medical costs. This project provided an important opportunity to review policy and service-delivery change mechanisms aimed at improving the reimbursement of mental health services in primary care settings. By using knowledge from a variety of individuals and settings and combining empirical research with qualitative interviews and the Expert Forum proceedings, this project identified areas where Federal agencies, states, provider organizations, and commissioner associations can clarify, collaborate, educate, and provide support to improve the reimbursement of and access to mental health services in primary care settings.


Primary Care

Primary Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 411
Release: 1996-09-05
Genre: Medical
ISBN: 0309175690

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Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.


Caring for People with Mental Health and Substance Use Disorders in Primary Care Settings

Caring for People with Mental Health and Substance Use Disorders in Primary Care Settings
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 123
Release: 2021-01-30
Genre: Medical
ISBN: 0309682681

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Behavioral health conditions, which include mental health and substance use disorders, affect approximately 20 percent of Americans. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. As many as 80 percent of patients with behavioral health conditions seek treatment in emergency rooms and primary care clinics, and between 60 and 70 percent of them are discharged without receiving behavioral health care services. More than two-thirds of primary care providers report that they are unable to connect patients with behavioral health providers because of a shortage of mental health providers and health insurance barriers. Part of the explanation for the lack of access to care lies in a historical legacy of discrimination and stigma that makes people reluctant to seek help and also led to segregated and inhumane services for those facing mental health and substance use disorders. In an effort to understanding the challenges and opportunities of providing essential components of care for people with mental health and substance use disorders in primary care settings, the National Academies of Sciences, Engineering, and Medicine's Forum on Mental Health and Substance Use Disorders convened three webinars held on June 3, July 29, and August 26, 2020. The webinars addressed efforts to define essential components of care for people with mental health and substance use disorders in the primary care setting for depression, alcohol use disorders, and opioid use disorders; opportunities to build the health care workforce and delivery models that incorporate those essential components of care; and financial incentives and payment structures to support the implementation of those care models, including value-based payment strategies and practice-level incentives. This publication summarizes the presentations and discussion of the webinars.


Care Without Coverage

Care Without Coverage
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 213
Release: 2002-06-20
Genre: Medical
ISBN: 0309083435

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Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.


Integrated Behavioral Health in Primary Care

Integrated Behavioral Health in Primary Care
Author: Mary R. Talen
Publisher: Springer Science & Business Media
Total Pages: 369
Release: 2013-06-04
Genre: Psychology
ISBN: 1461468892

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Contributed by experts who’ve developed integrative healthcare initiatives with strengths in the areas of policy and principles, organizational systems, or clinical practice. These contributors will illustrate the concepts and describe the nuts and bolts of their integration initiatives. In the conclusion of each section, the editors will construct a template to systematically evaluate these essential elements. This template will organize the information to help stakeholders compare and contrast the strengths, resources, limitations and challenges of how each model meets the vision of integrative healthcare. In the concluding section the information in the preceding sections connects to provide a coherent synopsis of the common themes and practices, from the macro to micro levels of care, which foster successful integration of the medical and psychosocial systems.


Integrated Care

Integrated Care
Author: Lori E. Raney
Publisher: American Psychiatric Pub
Total Pages: 292
Release: 2017-04-26
Genre: Medical
ISBN: 1615371338

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Integrated Care: A Guide for Effective Implementation provides a detailed, thoughtful, and experience-based guide to the complex and potentially overwhelming process of implementing an integrated care program. The advantages of integrated care from both the clinical and administrative perspectives are many, including better detection of illness, improvement in overall health outcomes, a better patient care experience, flexibility in responding to policy and financial changes, and an emphasis on return on investment. The book addresses the emerging framework of core principles for effective integrated care, reviews the most up-to-date research on implementation, and presents practice-based experience to serve as a guide. This information is useful in both traditional integration of behavioral health into general medical settings (often primary care) or integrating general medical care into a specialty mental health or substance use treatment setting. Because administrators, clinicians, policy makers, payers and others need guidance in determining what effective implementation looks like, the authors offer a three-part examination of the key components of an implementation strategy and explore the elements essential for success. The book is grounded in the authors' real-world expertise and offers readers practical, accessible information and support: Often efforts to implement an integrated care program fail because the model is more than just "plug and play." To address this misconception, the authors explore the successful implementation from every angle -- from leadership, primary care, therapist, psychiatric provider, and policy perspectives. As procedural and institutional hurdles are being overcome, codes for integrated care have been adopted. Accordingly, the book provides in-depth coverage of finance and funding models, challenges to billing, and emerging payment models. Each of the chapter authors were selected for their direct clinical experience in various integrated environments, their leadership in ushering teams through these initiatives, and/or their deep knowledge of payment and policy barriers. Impediments to the widespread implementation of evidence-based programs include payment and regulatory barriers, lack of a workforce trained in effective collaboration, and cultural differences between the worlds of primary care and behavioral health care. Integrated Care: A Guide for Effective Implementation helps health care leaders and providers overcome these obstacles to implement a successful, patient-centered integrated care program.