Electronic Health Records

Integration & Interoperability News

Will EHR Incentive Payments Help Integrate Behavioral Health?

By Kyle Murphy, PhD

In an effort to better integrate behavioral health and primary care, a new bill proposes to make mental health providers eligible for EHR incentive payments.

Introduced by Representatives Tim Murphy (R-PA) and Eddie Bernice Johnson (D-TX), the Helping Families in Mental Health Crisis Act of 2015 (HR 2646) includes several provisions related to the adoption of health information technology and health data exchange, with meaningful use eligibility likely the most significant.

“It is not just a new bill, but marks a new dawn for mental health care in America. We are moving mental health care from crisis response to recovery, and from tragedy to triumph,” Murphy said in a public statement. “I am tremendously proud of the work we’ve accomplished and so encouraged about our nationwide grassroots support involved in advancing our legislative vision to help families in mental health crisis.”

If enacted, the bill would include clinical psychologist providing qualified psychologist services" and "inpatient hospital that is a psychiatric hospital" under the respective categories of "additional eligible professional" and "additional eligible hospital" that currently define eligibility for EHR incentive payments.

With eligibility would also come the risk of Medicare payment adjustments for these newly minted eligible professionals and hospitals if they are fail to demonstrate meaningful use as part of the Medicare EHR Incentive Program.

Given the sensitivity of behavioral health information, the proposed bill also addresses issues of provider access to protected health information (PHI) for individuals with "serious mental illness."

Additionally, the legislation proposes focuses on the confidentiality of records within the context of accountable care organizations (ACOs) and efforts to improve care coordination.

Specifically, it names ACOs, health information exchanges (HIEs), and "other integrated care arrangement" in relation to health data exchange "for purposes of attaining interoperability, improving care coordination, reducing health care costs, and securing or providing patient safety" — that is, the triple aim.

Earlier this year, EHRIntelligence.com reported that a survey of behavioral health providers demonstrated that the costs of EHR implementation and adoption were the leading cause for not leveraging these health IT systems. More than 40 percent of respondents (41.3%) listed financials reasons, followed by nearly one-third (32.5%) reporting no need for EHR technology. (Being unable to find the right EHR system and staff resistance rounded out the remainder.)

Recently, the Office of the National Coordinator for Health Information Technology took aim as increasing behavioral health EHR adoption in its Federal Health IT Strategic Plan 2015-2020.

“It’s a critical piece of the puzzle to see that we can connect care and paint a picture of someone’s overall health in a more holistic way,” National Coordinator Karen DeSalvo, MD, MPH, MSc, said in December.

DeSalvo went on to explain a major problem for addressing behavioral health EHR adoption was a lack of information about the technology in use among these providers.

“We actually don’t have a baseline for the data, which is one of the challenges around understanding the degree of the challenge ahead of us as a country, but it is something that we have been discussing with this council,” she noted.

Given the successes of the EHR Incentive Programs in driving the adoption of certified EHR technology (CEHRT), financial incentives for behavioral health providers would put the health IT infrastructure in place for meaningful use health data exchange.




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