CMS has decided to implement a Behavioral Health Care Strategy to help people overcome mental health problems during the COVID-19 pandemic.
The COVID-19 pandemic has become the primary cause that puts societies, economies, and healthcare systems at stake. Numerous people have lost their jobs or families and separated for a long time. Furthermore, young people and children miss social opportunities and have no option but to isolate themselves. The pandemic has strained disabled patients and older adults in several ways, leading to substance-use disorders.
If you’re unfamiliar with SUD, let’s discover what it means.
Substance Use Disorder is a phenomenon in which a person uses an uncontrolled amount of alcohol, tobacco, and illicit drugs. People may become habitual in taking a certain amount to avoid distress and are impaired in performing day-to-day tasks.
To treat such severe health-related conditions, doctors suggested practicing mental health care services. To explore how it works with Medicare beneficiaries to overcome the national mental health crisis, we will learn about new approaches and briefly study their impact.
Many people, including children and adolescents, face post-traumatic stress with extended school breaks and fewer social gatherings. In addition, an obligation to follow social measures and safety protocols limited access to mental healthcare services. Therefore, the initiative of strengthening BHC has become more essential than any other service all around the globe.
Moreover, doctors and healthcare facilitators have considered behavioral healthcare affordable, quality, and timely service. Therefore, it’s necessary to make mental health systems strong by understanding the psychosocial needs of the people. In this regard, President Biden announced a strategy to balance equity among patients and avoid national healthcare crises.
Biden has emphasized transforming mental health care systems under American Rescue Plan. It aims to support organizations financially to expand access to services to those seeking them in the future. The objective of introducing a national mental health care strategy is to form a new infrastructure of health and social institutions to train workers. The breakdown of the national healthcare strategy includes:
Programs like Minority Fellowship Program, National Health Service Corps, and Behavioral Health Workforce Training and Education program will gain approximately $700 million from the President’s FY23 budget. These investments will empower the workflow and participation of mental health workers. In addition, they will improve their reach to the geographic areas.
It’s expected that HHS will award $225 in training for the additional workforce that will incorporate behavioral healthcare support for people. Hence, this initiative intends to develop facilitators’ capacity and emphasize improving mental health transformation.
The Biden-Harris Administration will summon stakeholders, launch development, and introduce nationally certified programs for peers to ensure healthcare system growth. These accredited programs won’t just get recognition; healthcare systems can utilize the skillset in the long run.
To treat an individual’s depression, the President’s FY23 budget will multiply twice the funding to equip primary care settings. Through quality treatments and available resources, they intend to nurture mental health and provide patient substance use care.
Keeping people healthy and saving lives are on the agendas catching the attention of various healthcare institutions, including CMS. Therefore, CMS has introduced its own BHS that promotes and focuses on person-centered mental and emotional well-being. Furthermore, it has also been searching for ways to remove barriers by adopting a data-informed approach.
So, what does CMS target in the BHS? Below, we’ll discuss goals briefly highlighted in the strategy designed to benefit Medicare or Medicaid beneficiaries.
CMS aims to access equity and quality in the BHC through telehealth and technology. They tried incorporating health equity in the payment models and new care structures to improve behavioral conditions. They have set the mission to educate beneficiaries, caregivers, and health service providers. They have emphasized utilizing linguistic or cultural materials to help people who are unaware of health protocols and have low English proficiency.
In addition to improving quality measurements, it’s essential to put quality and health equity implications across all goals in the CMS’s BHC strategy. This will help overcome substance-use disorders, pain-stress conditions, and behavioral health services.
Substance Use Disorder is a critical issue that has become the primary cause of death during pandemics. Therefore, CMS has been putting loads of effort into its prevention. In addition, they intend to increase strategic opportunities by providing high-quality, inexpensive, whole-person care services to the beneficiaries.
Through the BHC approach, they will address barriers to help people get treatment when they need it. Moreover, they have introduced innovative payment structures and recovery services focusing on detecting, diagnosing, and managing high-risk conditions. Finally, their services will expand to training health caretakers and residents to see and cure SUD to save lives and promote awareness.
To deal with challenges like the over-excessive use of Substances, they have created an opportunity under the authority of section 1115 for states. In Medicaid 1115 SUDD, CMS has introduced demonstration programs to alleviate the overdose crisis.
CMS urges caretakers to practice personalized, effective care to improve the continuum of pain treatment and management for patients dealing with chronic health conditions. Additionally, it will also focus on the guidance of the state. It will identify new coverages for the beneficiaries affiliated with Medicare or Medicaid. The effort to regulate pain treatment will improve primary and specialty care. It will also expand the workforce’s capacity to subdue acute pain conditions.
Collecting data is a practical approach to improving healthcare outcomes. Therefore, CMS will evaluate numbers through BHC across Private Health Insurance, Medicare, Medicaid, and Children’s Health Insurance Programs. It also intends to support evidence and data that can help achieve healthcare benefits for patients usually affected by emotional or mental stress trauma.
Regarding mental disorders and crises during the pandemic, mobilizing the BHC workforce within the community has become a critical approach. Marriage therapists, addiction counselors, licensed professional counselors, and certified peer recovery specialists can provide behavioral health services under general supervision.
Concerning mental well-being, the workforce or the practitioners will handle behavioral conditions without seeking a doctor’s help. Another objective of these practitioners is to expand patients’ access to quality cognitive behavioral treatment. Primarily, they will target rural areas and underserved communities where people hardly find help with resources.
To manage behavioral health needs, CMS will be paying practitioners and social workers so that they can utilize the best people to help others get BHC. Furthermore, Medicare has been collecting data to improve reaching people seeking such services. For example, some cases or healthcare conditions differ and need individualized care. So, instead of resorting to hospitalization, they can benefit from intensive care organized in the community.
After training practitioners and social workers, the next step is to supervise their job efficiency regarding the goals set under the BHC strategy by CMS. The best way to integrate the BHC approach is by working in teams. Therefore, Medicare has allocated a budget for team-based services, management, and chronic care treatment.
Medicare has recently introduced Shared Savings Program Accountable Care Organizations (ACOs) to help beneficiaries with mental healthcare needs. Healthcare providers, doctors, and hospitals will participate voluntarily to help people attain high-quality BHC services. Primarily, this program aims to prevent medical errors, duplicative tests, and unnecessary treatments. As a result, a person getting fully coordinated services will positively impact his health and help him combat chronic pains.
Depression and mental stress can affect anyone causing a severe breakdown. In the past, it’s reported that more than 20% of Americans have suffered from chronic pains. Moreover, more than 40% of people have been caught by depression, stress, mental disorder, and SUD. Therefore, Medicare has been working hard to adopt and initiate a concept of telehealth under the SSP program. They have introduced Telehealth Toolkit to help practitioners manage the social needs of people in inaccessible areas.
Telehealth Toolkit can empower two-way communication between a patient and the social caretaker through audio and video resources. It will not just sustain interactive communication but can reach people in the areas where physical help can’t go.
To understand how this works, let’s consider an example of diabetes and mental stress patients.
Patients suffering from depression and diabetes simultaneously can’t show enough energy to manage their medication, meals, and other schedules. In addition, treating diabetes alone with essential medical services won’t help cure depression if not catered to equally at the same time. Therefore, Medicare has assigned additional budgets to the ACO’s departments to hire practitioners and plan better solutions for people’s needs, including housing and food services.
Medicare plans to reconsider the Physician Fee Schedule on September 6, 2022. Lately, they have been reflecting on counseling services and increasing the budget for Opioid Treatment Programs to help people recover rapidly.
STL Medicare Benefits aims to keep its clients well-informed about the policies, treatments, coverages, and more related to Behavioral Healthcare Benefits. For us, your mental health and emotional well-being matter a lot. Therefore, whatever concern brings you to our door, we warmly welcome and prove ourselves worthy of your benefits to sustain a better healthy environment.
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