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Will Behavioral Health Be Left Behind?

March 30, 2009
by David Raths
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There's one group that may not be as thrilled as the rest of the healthcare field about the stimulus funding aimed at electronic health record adoption: behavioral healthcare providers.

While psychiatric hospitals and community behavioral health organizations are eligible to apply for some of the $2 billion in grant funding that will flow from the Office of the National Coordinator, they are left out of the larger (approximately $17 billion) funding in Medicare and Medicaid incentives for meaningful use of EHRs.

I recently interviewed Kevin Scalia, executive vice president for corporate development at behavioral health software company Netsmart Technologies. He also is chair of the Software and Technology Vendors Association (SATVA), a trade organization for providers of behavioral health software.

"We spend $180 billion on mental health each year in this country," Scalia told me. "It doesn't make any sense that those EHR incentives don't apply to mental health providers."

Behavioral health also may be a target group that needs the incentive funding most. Getting to full adoption of EHRs and participation in health information exchanges could be especially difficult in behavioral health. As Ron Manderscheid, director of mental health and substance use programs at Constella Group/SRA International in Rockville, Md., told me for an article for Behavioral Healthcare magazine last year: "Behavioral healthcare has been squeezed financially for years, so there is not excess money to pay for technology advances. The outcome is that we are years behind where we should be."

While the stimulus bill was being written, Scalia said, his company worked with the National Council for Community Behavioral Healthcare to try to have the Medicaid incentive language changed. They were not successful, he added, because there was a concern that it would increase the cost of the incentive section above the $20 billion mark.

Should Congress modify that section of the law? Or will enough of the grant funding target behavioral health providers to help them catch up with the rest of the industry technologically?

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Comments

Let's not forget that one of the biggest stumbling blocks to any HIE effort is privacy concerns. HITECH has many provisions that rewrite the PHI laws, putting a much higher burden on providers to safeguard that data. Nowhere is PHI more coveted than in the behavioral healthcare field, where a leak, combined with the publication powers of the Internet, can destroy lives otherwise on the mend. Behavioral healthcare and HIE? That's a tough one.

David,
Thank you for this post. I can't explain why, but I was unaware of this situation, and I find it inexcusable, particularly when Congress was informed of this shortfall before ARRA was enacted.

The $2 billion available in grants will in no way stretch to the point where behavioral health can catch up with technology. My kneejerk reaction was that Congress should amend ARRA immediately. However, after thinking about this for a while, I've come to another conclusion.

It appears to me that by waiting for funding of EMRs to generate positive results before asking for targeted funding to cover behavioral health, that segment may be rewarded with greater support. The public is almost universally in favors of EMRs, so if ARRA generates benefits, it is reasonable to presume that taxpayers would support separate legislation that solely funds technology for behavioral health.

Sometimes it's better to get a modest size fresh pie that's all your own, rather than a sliver of one that's already been, for the most part, devoured.

Jack

David Raths

Contributing Editor

David Raths

@DavidRaths

www.linkedin.com/in/davidraths

David Raths’ blog focuses on health IT policy issues ranging from patient privacy to health...