Medicaid plans can now pay mental health institutions. Most won’t until 2017

http://www.modernhealthcare.com/article/20160705/NEWS/160639991

A policy that lifts a 50-year ban on Medicaid pay for mental health institutions kicked in Tuesday, but it may be months before many enrollees can take advantage of the new coverage

Since the creation of Medicaid in 1965, the program has excluded payment for institutions of mental disease (IMDs) for beneficiaries 21 and over. Most residential treatment facilities for mental health and substance-use disorders with more than 16 beds did not qualify for Medicaid reimbursement.

Providence St. Joseph Health System Merger Creates $100 Million Mental Health Initiative

Providence St. Joseph Health System Merger Creates $100 Million Mental Health Initiative

Concussions

4 forces that will influence medical cost trends in 2017

http://www.healthcaredive.com/news/4-forces-that-will-influence-medical-cost-trends-in-2017/421162/

Binoculars

The healthcare industry is in a transformational period. The rising use of retail clinics, MACRA, population health efforts and the Medicare Part B demonstration are but a few examples of disruptive conversations being had in board rooms. Yet, all of these discussions are underscored by the one topic underlying most business conversations: the almighty dollar.

There’s a push and pull between healthcare services utilization and narrow networks focusing on value that could shift the medical cost growth rate in future years. “When medical growth outpaces general inflation, a flat trend is not good enough,” the report states.

“As a result, 2017 will be a tough balancing act for the health industry,” the report states, adding, “Healthcare organizations must simultaneously increase access to consumer friendly services while decreasing unit cost. Employers, worried that this current trend is at an inflection point that could turn back up, will demand more value from the health industry.”

Congress Should Act on Mental Health

https://morningconsult.com/opinions/congress-act-mental-health/

mental-health

Conventional wisdom says that Congress generally won’t achieve much in a Presidential election year as issues begin to get mired in partisan posturing.  But 2016 has been anything but a conventional election year, and this Congress has the opportunity to pass two important bipartisan health bills this year.

We’re talking about the mental health bills before the House and the Senate as well as the Medicare chronic care legislation under development by the Senate Finance Committee.  These bipartisan proposals could improve the lives of millions of Americans and move our health care system in the direction of better integrated and higher value care. It’s time that Congress act on them.

Chronic disease already accounts for the vast majority of health care costs in Medicare and our health care system in general.   Without action, the problem will only get worse.

Largest Share of Health Spending is on Mental Disorders

http://www.healthleadersmedia.com/finance/largest-share-health-spending-mental-disorders?spMailingID=9084486&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=941950601&spReportId=OTQxOTUwNjAxS0

Mental Illness Awareness

Reductions in deaths from cardiovascular and cerebrovascular disease are likely to drive spending on mental disorders even higher, as more people survive to older ages when mental disorders become more prevalent.

How Gun Control Politics Is Delaying Major Mental Health Reform

http://www.thefiscaltimes.com/2016/04/19/How-Gun-Control-Politics-Delaying-Major-Mental-Health-Reform?utm_campaign=541c47950e351dbe08037e5f&utm_source=boomtrain&utm_medium=email&bt_alias=eyJ1c2VySWQiOiJkN2QxNDRmNC1lMmY5LWRjNGMtZDg1ZC00MjExYTQ2NzI1M2UifQ%3D%3D

Capital Building2

Houston psychiatrist sentenced 12 years for $158 million Medicaid fraud

http://www.healthcarefinancenews.com/news/houston-psychiatrist-sentenced-12-years-158-million-medicaid-fraud?mkt_tok=eyJpIjoiWWpNeFlqZ3hOekZrTW1NNSIsInQiOiJrbUR5S0JXcWFyQW1VcHhDZWxNbGJoOFI5cUdJZmdSdmNXOFV4cGRNSnpsTVBYQ0pMcEhrb2hTbkwyVUlHYUdLT2JPVTNXRFl1Q0p2NUdEMHZ5RTNpTmluU2VyYmRWOTFjZWZZVXp2ejQ5dz0ifQ%3D%3D

Fraud3

Sharon Iglehart was also ordered to pay more than $6 million in restitution, Department of Justice says.

In Annual Baseline Budget Projections, CBO Decreases Marketplace Enrollment Estimates (Update)

http://healthaffairs.org/blog/2016/03/25/in-annual-baseline-budget-projections-cbo-decreases-marketplace-enrollment-estimates/

Tim-ACA-slide

Texas Doc of the Year Builds Rural Care Network

http://www.healthleadersmedia.com/community-rural/texas-doc-year-builds-rural-care-network

Dr. Jasmine Sulaiman, M.D., Staff Care’s 2016 Country Doctor of the Year

http://www.staffcare.com/about-us/country-doctor-award/

When the Hospital Fires the Bullet

More and more hospital guards across the country
carry weapons. For Alan Pean, seeking help for
mental distress, that resulted in a gunshot to the chest.