A landscape with depressions, steep hills, and gaps
This post first ran on the Cohen Veterans Network and can be accessed here.
On September 27 and 28, the second annual Cohen Veterans Care Summit will be taking place at the Ronald Reagan Building in Washington, DC. The Cohen Veterans Network is pleased to be a co-host and leader of numerous sessions this year at the Summit, including a session on mental health reimbursement and parity.
The Cohen Veterans Network is a growing national private non-profit clinically integrated mental health system for veterans and military families. CVN is funded by Steven A. Cohen with a long-term sustainment strategy that includes insurance reimbursements, state mental health grants, and philanthropy. This model of funding is essential if you want to provide exceptional mental health care in today’s current reimbursement landscape.
In growing our network, I have quickly learned that without additional financial resources, we would not be able to offer accessible high-quality care with a skilled workforce given the current reimbursement margins. The cost to deliver mental health care is high and the Medicaid/Medicare/Private Insurance reimbursement rates are low. So, how do other community-based mental health organizations survive in this high demand, high acuity, and low reimbursement environment? My assessment is that they struggle at best, and their customers likely suffer in silence waiting for access. It is difficult to meet the endless demand for mental health services with qualified clinicians and staff when most of your efforts are focused on keeping the doors open. And, for this highly-stigmatized population, they are left unable to access services when they desperately need them.
Simply stated, access to mental health care is jeopardized by the steady decline in reimbursement rates for mental health providers. Mental health providers are choosing to not accept insurance and lean towards cash-only private practices which, as we know, excludes millions in desperate need for mental health services. Not to mention, the difficulty for community mental health centers to efficiently operate their organizations and maintain a skilled workforce while ensuring timely access to quality care.
While the Mental Health Parity Act was supposed to level the playing field between mental health care and general health care, it has done little to support the actual reimbursement rates for providers and organizational infrastructure needed to provide mental health treatment. Let’s face it, everything these days is driven by compensation, and yet everything has been cut to the core. What mental health provider is going to want to work for less and have to fight reviewers to get paid? In this environment, mental health organizations are also forced to focus on volume in order to come out ahead, which detracts from the quality of care. This is frightening when one considers that more than half of Americans with a mental illness do not receive care. And, as fewer providers are willing to see insured patients, other providers are asked to take on more visits, resulting in patients experiencing longer delays to access care. What a tragedy!
To not sound so gloom and doom, I want to share a few strategies being deployed within the Cohen Veterans Network and other organizations across the country that offer solutions to address the aforementioned challenges.
- Develop appropriate infrastructure so care can be provided as efficiently as possible, such as clinical guidelines, patient navigators, and tele-mental health/technologies
- Measure and report outcomes to improve care while demonstrating value and quality
- Hire leadership that understands both the clinical issues and financial challenges
- Consolidate or collaborate (such as program sharing) for better efficiency and scale to deliver care
- Seek philanthropic partners or collaborators, to sustain operations, add services and develop pilot programs
Our panel at the Cohen Veterans Care Summit is comprised of esteemed professionals who will discuss these important issues.
- Susan Huntington, JD, PA, Counsel at Day Pitney
- Charles “Chuck” Ingoglia, MSW, Senior Vice President, Public Policy and Practice Improvement, National Council for Mental Wellbeing
- Jeff Richardson, MBA, LCSW-C, President and Chief Executive Officer of Mosaic Community Services
- Moderator: Anthony Hassan, EdD, LCSW, Chief Executive Officer of Cohen Veterans Network