Healthcare Reform

Purpose

The Purpose of the MNS Healthcare Reform Committee (HRC) is to:

  1. Keep MNS members and the Board of Directors informed about federal and state healthcare reform trends and developments.
  2. Provide recommendations to the MNS Board of Directors (BOD) about building community relations, issuing public comments, and taking other informational actions in the MNS community or in the larger regulatory, legislative, and healthcare arenas. The goal of these efforts is to keep MNS and neuropsychology services vital and engaged as healthcare systems evolve. For more details, please see our mission statement.

 

Neuropsychologists in-the-know  

  1. Purchase the webcast from the 2015 Multi-State Summit: Delineating Alternative Practice, Legal and Financial Models for Integration -- The Next Phase of Health Care Reform: Practical Steps for New Practice and Business Models for Psychologists/Neuropsychologists: www.nyspa.org/
  2. Terms, trends, practice issues and solutions, and more -- related to Patient Protection and Affordable Care Act (ACA for short) available on the IOPC Toolkit website: http://neuropsychologytoolkit.com/

 

At the State Level

Massachusetts had a head start in implementing healthcare reforms. The federal Affordable Care Act (ACA) is modeled on the 2006 MA healthcare reform law, which required all citizens in the Commonwealth to have health insurance and established insurance exchanges. Furthermore,  in 2012, MA Chapter 224 became law: An Act Improving the Quality of Health Care and Reducing Costs through Increased Transparency, Efficiency and Innovation. The schedule for implementing specific elements of this act, focused on healthcare delivery systems and payment reform, is at the end of the law.

Chapter 224 established the Health Policy Commission, which is charged with advancing “ a more transparent, accountable, and innovative health care system through independent policy leadership and programs.  Our goal is better health and better care at a lower cost across the Commonwealth.” The HPC solicits input from healthcare stakeholders in developing new models of care, such as Patient Centered Medical Homes. Chapter 224 also established the Behavioral Health Integration Task Force, which made recommendations regarding delivery of behavioral health services  in June 2013. Read the Task Force’s final report to the MA Legislature and the MA Health Policy Commission here.

In evolving healthcare systems, electronic health records (EHR) are central to providing integrated care. The Mass HIway is the Massachusetts Health Information Exchange (HIE), www.mass.gov/hhs/masshiway designed to allow all healthcare clinicians to “push” (send) and “pull” (access and receive) patient information via this secure electronic communication network. An EHR system is not required to connect. For information on how to enroll and/or sign up to receive newsletter, go to: http://www.masshiway.net/

Although MA Chapter 224 states that all healthcare providers will implement fully interoperable electronic health records (EHR) systems that connect through the Mass HIway by January of 2017, regulations to implement this have not yet been issued. It remains unknown how this will apply to solo and small-group behavioral health clinicians, In May 2016, the Mass HIway announced: "It is anticipated that connection requirements will be phased in over a number of years, with the initial focus on hospitals and larger ambulatory practices.  Draft regulations are expected to be presented for public comment later this year. The Mass HIway team will keep the community updated.  Any updates regarding EHR regulations and behavioral health will be posted here. Medical practitioners governed by the Board of Medicine are further along in adopting EHR's than are behavioral health clinicians.  Various task forces are discussing how to reconcile the unique privacy concerns in behavioral health and the prevalence of solo behavioral health practitioners with use of EHR's.  Patients must give consent for their healthcare information to be transmitted via the MassHIway.  The Mass eHealth Institute is the state agency coordinating information technology innovation and use, working closely with the MA Executive Office of Health and Human Services (EOHHS). 

 

At the Federal Level

From CMS (Centers for Medicare & Medicaid Services): “Health and Human Services has set a goal of tying 30 percent of Medicare fee-for-service payments to quality or value through alternative payment models by 2016 and 50 percent by 2018. HHS has also set a goal of tying 85 percent of all Medicare fee-for-service to quality or value by 2016 and 90 percent by 2018.”  5 Medicare Pioneer ACO’s are in Massachusetts. “Next Generation” ACO’s are expected in 2016.

CMS established the Health Care Planning Learning and Action Network (HCPLAN) which collects information from healthcare stakeholders and offers electronic news and webinars on ongoing developments in Alternative Payment Models.  You can sign up to receive news and alerts: https://publish.mitre.org/hcplan/

 

Questions? Or if you’d like to join the HRC, please contact the HRC Manager.

 

Watch the MNS listserv and this space for updates.
 
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