The vast majority of the healthcare reform advocacy opportunities are at the state level. Each state has significant leeway to set rules and regulations that favor, or ignore behavioral health. And frankly, few if any policymakers are discussing neuropsychology. So if we want to be written in to the new healthcare system, beginning with state level advocacy is by far the most effective option.
Identifying key public and private sector committees that are creating healthcare regulations in your state, and making sure that a neuropsychologist is on those committees is a very good place to start. To ensure that wheels are not being re-invented, and advocacy efforts overlapping, contacting your state psychological and neuropsychological organization is key.
Below are links State Psychological Associations and regional or State Neuropsychological Societies, and news and upcoming events from each state/ region. As information becomes available, we will add documents, upcoming events, and other resources generated by each state.
The Arizona Psychological Association is holding a leadership retreat for their Board in January 2013 to plan state level healthcare strategy.
Healthcare Reform Point Person: Charles Filanosky, PhD
Healthcare Reform Point Person: Nancy Hoffman, PsyD
The California Psychological Association recently sponsored a multidisciplinary Health Care Summit. The event was well attended by California psychologists as well as national leaders in health care reform (including Drs. Katherine Nordal, Elena Eisman, and Ben Miller). Dr. Michael Ritz chaired the Summit and brought together leaders from other health care organizations including Nurse Practitioners and the President of the California Medical Association. Read more about the summit.
HPA Healthcare Reform Point Person: Tanya J. D'Avanzo, Ph.D., ABPP-Cn
IPA Healthcare Reform Point Person: Dennis Woody, PhD
Point Person for Healthcare Reform: Neil Pliskin, PhD, ABPP-CN
IPA Healthcare Reform Point Person is Jon C. Thompson, PsyD, ABPP-CN
Healthcare Reform Point Person: Derek Grimmell, Ph. D.
Iowa psychologists and neuropsychologists have been focused on a recently-completed Behavioral Heath re-Design that updated and streamlined their statewide system, which was previously county-based. They will now turn their attention to the Affordable Care Act. Implementation of the ACA is on their agenda for a February 13, 2013 Legislative Breakfast, where psychologists are meeting with legislators to discuss a number of issues related to mental health care in the state. Read more
Kendra Bryant, Ph.D., ABPP-CN is MEPA's point person for healthcare reform.
Maine has opted to cede responsibility for the creation of exchanges to the federal government, and has rejected the Medicaid expansion under health care reform. However, a recent shift in the control of the legislature may change those positions before 2014.
There are several ACOs around the state in the planning stages and one non-profit has been the recipient of a large federal start up grant.
Mary Coakley-Welch, Ph.D. is the point person for healthcare reform for MNS
Massachusetts has been a year or two ahead of the nation in healthcare reform. Our exchange is up and running, with 98% of the population insured. 5 Medicare Pioneer ACO Pilots are located in large hospital systems in Eastern Massachusetts, placing more than 50% of Medicare recipients in the region in ACO structures. BCBSMA, our largest insurer has 75% of its HMO population in "Alternative Quality Contracts" which are ACO structures with global payments.
A healthcare reform bill was passed in 2013 that integrates behavioral healthcare into the broader healthcare delivery systems. Key behavioral healthcare provisions in this bill include:
- Establishment of a Behavioral Health Task Force to examine: delivery of behavioral health services; the extent to which and how behavioral health payments should be included under alternative payment methods; how mental health parity and patient choice of providers and services can be achieved; and integration of behavioral health services into primary care settings. The law mandates a place on the behavioral health task force be reserved for a representative from the Massachusetts Psychological Association. This is a major step forward. Elena Eisman, Ed.D., MPA Executive Director will be representing MPA on the task force.
- Mental health professionals (not just MDs) who meet specified criteria will have access to funds and interest-free loans for establishing electronic medical records.
- Healthcare Workforce Centers will include mental health and behavioral health services as they monitor and develop a healthcare workforce that is educated, trained, and retained to meet patient needs. This includes loan forgiveness programs for mental health professionals working in designated underserved geographic areas or working with designated underserved populations.
- The Division of Insurance must promulgate regulations requiring insurance carriers and contractors to comply with mental health parity laws. Private health insurers are required to submit an annual report certifying compliance with parity mandates, and the reports are subject to public review and hearing by DOI and the Attorney General’s Office.
- The healthcare bill also included language that requires medical necessity criteria sets be evidence based and transparent.
The Massachusetts Neuropsychological Society and Massachusetts Psychological Association engaged in a year long joint education series on healthcare reform and neuropsychology.
- 03/06/12 Neuropsychology and Healthcare Reform: Are we at the table? (Video download available)
- 10/27/12 Stakeholder's conference on neuropsychological and psychological report writing (Video available soon)
- 11/10/12 The Train is Leaving the Station: Get on Board with Models of Integrative/Collaborative Treatment That Workbetween Psychologists and Other Healthcare Providers
- 11/10/12 Writing better pediatric assessment reports: learning through listening to our colleagues
As of October 1, 2013, the current Massachusetts health insurance exchange, MAhealthconnector.org (established under MA 2006 state healthcare reform), will offer a state-of-the-art, web-based Health Insurance Exchange (HIX) -- Integrated Eligibility System (IES).
The new system will streamline eligibility determinations for subsidized health insurance programs through real-time data matching with state and federal databases (IES). It will also be the marketplace where any individual can buy affordable and qualified health plans (HIX). Once available on OCTOBER 1, 2013, the HIX -- IES system will allow applicants to apply for coverage that will be EFFECTIVE JANUARY 1, 2014.
Glossary: Health Insurance Exchange (HIX): A web-based computer system that acts as a health insurance marketplace to help individuals shop for coverage in a way that permits comparison of available plan options based on price, benefits and services, and quality. -- MassHealth Publications
The Massachusetts Neuropsychological Society presented a series: Honing Our Craft: Practical Skills for a 21st Century Practice.
First event: March 5, 2013: MNS In-House Forum on Report Writing.
Slides with audio from this event will be available soon. Watch this space for access to the program’s overview of neuropsychological assessment in the era healthcare reform featuring preliminary results from the national neuropsychologist and physician surveys on neuropsychological reports and discussion of the implications and strategies for writing reports based on the data.
Second event: May 7, 2013 "Integrating Sleep Management into Clinical Practice with Children, Adolescents, and Adults."
Catherine Schuman, PhD discussed several sleep disorders and the evidence supporting efficacy of cognitive-behavioral treatments. Lectures like this one equip neuropsychologists to improve patients' health and lives, along with equipping us to improve the efficiency, quality, and efficacy of healthcare systems. Neuropsychologists can (a) help the treatment team identify behaviors, such as atypical sleep patterns, that impact health in fundamental areas including weight management, cognition, and cardiovascular functioning. We can (b) recommend or provide specific, evidence-based interventions to treat the sleep problems.
The Massachusetts Neuropsychological Society (MNS) has announced establishment of its Healthcare Reform Committee (May 2013). The Committee is tasked with keeping MNS members and MNS leadership up-to-date on healthcare trends and developments, as well as on opportunities for education and advocacy regarding neuropsychology services within new healthcare models.
The Massachusetts Attorney General's Office (AGO) announced success in holding several insurance carriers accountable for failing to comply with Massachusetts healthcare law, including mental health parity provisions. The Attorney General also wrote to AHIP (America's Health Insurance Plans ) regarding those settlements and her plans to pursue enforcement action for future failures to follow MA law covering mandated mental health benefits.
Excerpt from the letter:
"I will continue to pursue enforcement actions against health insurance carriers that fail to comply with Massachusetts law because these services, including mental health services, are critically important. Failure to provide coverage of important mandated mental health benefits has a severe and detrimental impact on individuals who need those services, their families, and even their communities."
Karen Wills, Ph.D., ABPP-CN is the point person for healthcare reform for the Minnesota Psychological Association
The Minnesota Psychological Association is educating psychologists and neuropsychologists in preparation for implementation of The Affordable Care Act (ACA) and MN state health care reforms. In February, Dr. Trisha Spark spoke at their Friday Forum on "Impact of Health Reform on the Process and Content of Psychologists’ Work: Accountable Care Organizations (ACOs), Insurance Exchanges, Common Benefit Sets, Bundled Payment, Electronic Health Records, and Quality Measures.”
The upcoming April 5 - 6, 2013 MPA Annual Convention, "Surviving and Thriving: Psychology in the Era of Health Care Reform" features workshops that address the evolutionary changes underway in the health care system and how those impact professional psychology. Session topics include: how assessment and treatment can expand beyond a strictly mental health focus to a broader health care focus that allows for partnering within the larger health care arena; transitioning to EHR (electronic health records); neuropsychological and psychological assessment issues including billing codes, pre-authorization, and preparing for the impact of the ACA; new career paths for new graduates; and diversity and cultural competence in light of the ACA's directives for addressing mental health care disparities. For details: http://www.mnpsych.org/wpcontent/uploads/2013/03/MPA_ConfSchedule2013.pdf
The Minnesota Psychological Association is devoting their annual conference to healthcare reform:
Chris Morrison, PhD is the Healthcare Reform Point Person for NYSAN
NYSAN formed a HCR Committee to monitor developments in state and national approaches to healthcare reform, bring these developments to the attention of the NYSAN BOD and membership, and to act on the information obtained as appropriate and in the best interests of neuropsychology. The committee strives to seek opportunities for direct involvement in the shaping of health care reform in NYS, and to communicate and educate neuropsychologists on HCR developments as they relate to the practice of neuropsychology.
In an effort to educate neuropsychologists on HCR developments, the committee developed a series of conferences.
HCR Summit 2 provided two information-based and two skill-based talks geared toward helping neuropsychologists better prepare themselves to adjust to the changing practice environment that HCR will bring. The DVD is available here
New York Neuropsychology Grou
Healthcare reform point person: Richard Root, EdD
Washington, Oregon, Idaho, Western Canada
9/10/2012, PNNS hosted a CE program in Seattle that featured Mark Barisa, PhD, ABPP, Ethical Business Practices in Neuropsychology in a Changing Healthcare Market (Click here for link to powerpoint)
Steve Meharg, Ph.D. is the point person for healthcare reform at PNNS
Healthcare reform point person: Martin Boone, PhD