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Comprehensive Analysis: Behavioral Health Care Amid COVID-19 Crisis

Comprehensive Analysis: Behavioral Health Care Amid COVID-19 Crisis

The COVID-19 pandemic has emerged as a formidable threat, jeopardizing societies, economies, and healthcare systems worldwide. Countless individuals have endured job losses, family separation, and prolonged isolation. Young people, in particular, have grappled with the absence of social interaction, leading to feelings of loneliness and despair. The pandemic’s impact has also been significant for disabled individuals and older adults, often leading to substance-use disorders (SUDs) as a coping mechanism.

Understanding Substance Use Disorders (SUDs)

SUDs are characterized by the uncontrolled consumption of substances like alcohol, tobacco, and illicit drugs. Individuals struggling with SUDs may develop a dependence on a specific quantity of the substance to avoid withdrawal symptoms and experience difficulty fulfilling daily tasks.

The Necessity of Behavioral Health Care

To address these complex health concerns, healthcare professionals emphasize the significance of accessible and effective behavioral health care services. This analysis delves into how behavioral health care (BHC) can empower Medicare beneficiaries to overcome the national mental health crisis and explores new approaches along with their potential impact.

Why Has BHC Gained Significance During COVID-19?

The pandemic has triggered widespread mental health issues, including post-traumatic stress disorder (PTSD) in children and adolescents due to extended school closures and limited social interaction. Social distancing measures and safety protocols have further restricted access to essential mental health services. Consequently, strengthening BHC has become an urgent global priority.

Furthermore, healthcare professionals recognize the importance of affordable, high-quality, and timely BHC services. Building robust mental health systems requires a comprehensive understanding of individuals’ psychosocial needs. In response to this growing concern, President Biden has implemented a national strategy to ensure equitable access to mental healthcare and prevent a nationwide crisis.

President Biden’s Initiative for Mental Well-Being

President Biden’s American Rescue Plan prioritizes the transformation of mental health care systems. This plan aims to financially support organizations in expanding access to services for those seeking help. The national mental health care strategy envisions a new infrastructure of healthcare and social institutions equipped to train additional mental health workers. Here’s a breakdown of the key components of this national strategy:

  1. Investment in Proven Programs: Established programs like the Minority Fellowship Program, National Health Service Corps, and Behavioral Health Workforce Training and Education Program will receive a significant financial boost of approximately $700 million from the President’s FY23 budget. This investment aims to empower existing mental health workers, enhance their workflow and participation, and improve their geographical reach.
  2. Training a Larger Workforce: The Department of Health and Human Services (HHS) plans to allocate $225 million to train a supplementary workforce capable of integrating BHC support for individuals. This initiative aims to develop the capacity of facilitators and prioritize improvements in mental health transformation.
  3. Introducing a National Certification Program: The Biden-Harris Administration will collaborate with stakeholders to develop and launch nationally recognized certification programs for peer support specialists. These accredited programs will not only offer recognition, but also equip healthcare systems with a skilled workforce to manage future demand.
  4. Equipping Primary Care Settings: To address issues like depression, President Biden’s FY23 budget proposes doubling the funding for equipping primary care settings. This initiative aims to enhance access to quality treatment and essential resources for mental health and substance use disorder care.

The CMS’s Introduction of a Behavioral Health Strategy

Preserving health and saving lives are central to the mission of various healthcare institutions, including the Centers for Medicare & Medicaid Services (CMS). In line with this objective, the CMS has introduced its own Behavioral Health Strategy (BHS) that prioritizes person-centered mental and emotional well-being. Additionally, the CMS seeks to eliminate access barriers through a data-driven approach.

Goals of the CMS's BHS for Medicare and Medicaid Beneficiaries

Goals of the CMS’s BHS for Medicare and Medicaid Beneficiaries

Here’s a closer look at the core objectives outlined in the CMS’s BHS, designed to benefit Medicare and Medicaid beneficiaries:

Objective 1: Achieving Equity and Quality in BHC Delivery

The CMS aims to leverage telehealth and technology to ensure equitable access to high-quality BHC services. Integrating health equity into payment models and establishing new care structures are crucial aspects of this objective. The CMS is committed to educating beneficiaries, caregivers, and healthcare providers. Notably, the strategy emphasizes the use of culturally and linguistically appropriate materials to assist individuals with limited English proficiency or those unaware of relevant health protocols.

Furthermore, the CMS recognizes the importance of integrating quality and health equity considerations across all BHS goals. This comprehensive approach aims to effectively address SUDs, pain management, and behavioral health needs.

Objective 2: Prevention, Treatment, and Recovery Services for SUDs

SUDs are a critical public health concern, particularly during pandemics as they can contribute significantly to mortality rates. The CMS is actively working to prevent SUDs through various initiatives. Additionally, they aim to increase access to high-quality, affordable, and holistic care services for beneficiaries.

The BHC strategy focuses on eliminating barriers that prevent individuals from seeking treatment. Innovative payment structures and recovery services are being developed to target detection, diagnosis, and management of high-risk conditions. The CMS is also expanding training programs for healthcare workers and residents to equip them with the skills necessary to identify and treat SUDs, ultimately saving lives and promoting awareness.

Specific to the challenge of over-consumption of substances, the CMS has created opportunities under Section 1115 for states. The Medicaid 1115 SUD Demonstration programs aim to alleviate the national overdose crisis.

Objective 3: Regulating Pain Treatment and Management

The CMS encourages healthcare providers to adopt personalized and effective pain management strategies for patients with chronic health conditions. This objective also emphasizes state-guided approaches to identifying new coverage options for Medicare and Medicaid beneficiaries. Efforts to regulate pain treatment will lead to improvements in both primary and specialty care. Additionally, the BHS aims to expand the workforce’s capacity to manage acute pain conditions.

Objective 4: Data Collection and Implementation of Effective Actions for BHC

Data collection is a cornerstone of improving healthcare outcomes. The CMS will be evaluating BHC data across various programs including Private Health Insurance, Medicare, Medicaid, and Children’s Health Insurance Programs. This data will be used to generate evidence-based practices that can improve healthcare experiences for patients struggling with emotional or mental health challenges.

Mobilizing the BHC Workforce Within Community Settings

During the pandemic, mobilizing the BHC workforce within communities has become a critical strategy to address mental health issues and crises. Marriage and family therapists, addiction counselors, licensed professional counselors, and certified peer recovery specialists can provide valuable BHC services under general supervision.

These BHC professionals can manage behavioral health conditions without requiring immediate doctor involvement, expanding access to quality cognitive behavioral therapy (CBT) for patients. Their focus will be on serving rural areas and underserved communities where access to resources and qualified professionals is often limited.

To effectively manage BHC needs, the CMS will compensate practitioners and social workers, ensuring the best possible care for individuals seeking BHC services. Medicare is also actively collecting data to improve outreach efforts and tailor services to specific needs. For instance, some patients may require intensive, in-home care instead of traditional hospitalization.

Medicare’s Role in Enhancing Behavioral Health Care

Following the training of practitioners and social workers, the next step is to ensure their effectiveness in achieving the goals outlined in the CMS’s BHS. Collaboration and teamwork are vital to successfully integrate BHC services. To facilitate this, Medicare has allocated a budget specifically for team-based services, care management, and chronic disease treatment.

Importance of Medicare Shared Savings Programs (SSPs) and their Potential Medicare has recently introduced Shared Savings Program Accountable Care Organizations (ACOs) to provide mental health support to beneficiaries. This program allows healthcare providers, doctors, and hospitals to participate voluntarily in offering high-quality BHC services. The primary focus is on preventing medical errors, unnecessary tests, and redundant treatments. Ultimately, these coordinated services contribute to improved patient health outcomes, including chronic pain management.

Addressing Social Needs Through Telehealth

Depression, stress, and mental health challenges can have a debilitating impact on individuals. It’s estimated that over 20% of Americans suffer from chronic pain, and more than 40% grapple with depression, stress, mental disorders, or SUDs. In recognition of these challenges, Medicare has adopted telehealth services under the SSP program. The Telehealth Toolkit empowers two-way communication between patients and social workers through audio and video tools. This approach not only fosters interactive communication, but also allows for remote support in areas with limited access to in-person services.

For instance, a patient with both diabetes and depression might lack the energy to manage medications, meals, and other daily routines effectively. Treating just the diabetes with traditional medical services wouldn’t address the underlying depression. Therefore, Medicare has allocated additional resources to ACOs to hire BHC practitioners who can develop comprehensive care plans that address patients’ social needs, including housing and food security.

Staying Updated on Medicare BHC

Medicare plans to revisit the Physician Fee Schedule on September 6, 2022. Recent discussions have focused on expanding counseling services and increasing funding for Opioid Treatment Programs to expedite recovery efforts.

At STL Medicare Benefits, we prioritize keeping our clients informed about BHC benefits, policies, treatments, and coverage options. We recognize the importance of mental health and emotional well-being, and we are dedicated to providing you with the necessary resources to thrive in a healthy environment.

Conclusion: A Brighter Future for Mental Health

The COVID-19 pandemic has undeniably cast a long shadow on mental health. However, the increased focus on BHC services offers a beacon of hope. By prioritizing accessibility, affordability, and quality care, the initiatives outlined above pave the way for a more comprehensive approach to mental well-being.

Looking Forward: Areas for Continued Development

Despite the significant progress, there’s still room for improvement. Here are some key areas for ongoing development:

  • Stigma Reduction: Stigma surrounding mental health issues remains a significant barrier to seeking help. Continued efforts are needed to raise public awareness and normalize conversations about mental health.
  • Integration with Physical Healthcare: BHC should be seamlessly integrated into primary care settings to ensure holistic well-being. This can involve co-location of BHC professionals within primary care clinics or the establishment of collaborative care models.
  • Technological Advancements: Telehealth and other digital tools offer immense potential for expanding access to BHC services, particularly in remote areas. Continued investment in telecommunication infrastructure and user-friendly technology is crucial.
  • Culturally Competent Care: Delivering culturally competent care is essential to addressing the unique needs of diverse populations. Training for BHC professionals on cultural sensitivity and ensuring a representative workforce are key strategies.
The Road to a Healthier Future

The Road to a Healthier Future

By addressing these areas, we can build a future where mental health receives the same level of attention and resources as physical health. Investing in BHC services not only improves individual well-being but also strengthens communities and society as a whole.

Taking the Next Step

If you are struggling with mental health challenges, there is help available. Here are some resources to get you started:

Remember, you are not alone. With the right support, you can overcome mental health challenges and lead a fulfilling life.

A Note from STL Medicare Benefits

STL  Medicare Benefits is here to support you on your journey to mental well-being. We can help you understand your Medicare coverage for BHC services and connect you with qualified providers. Don’t hesitate to reach out to us for further assistance.

We hope this comprehensive analysis has provided valuable insights into the importance of BHC services and the ongoing efforts to improve mental health care.

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