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CEO Update | 53

CMS Proposes 1.7 Percent Increase for Inpatient Psychiatric Facilities in 2020 The Centers for Medicare & Medicaid Services (CMS) on Thursday proposed a 1.7-percent payment increase for inpatient psychiatric facilities (IPF) in 2020, which the agency estimates will increase total IPF payments by about $75 million. In addition, CMS proposed adopting one new claims-based measured starting with the fiscal year 2021 payment determination and continuing in subsequent years. The measure—Medication Continuing Following Inpatient Psychiatric Discharge (National Quality Forum #3205)—assesses whether patients admitted to IPFs with diagnoses of Major Depressive Disorder, schizophrenia, or bipolar disorder filled at least one evidence-based medication within two days before discharge or during the 30-day, post-discharge period. Also in 2020, CMS has proposed to rebase and revise the IPF market basket to reflect a 2016 base year from a 2012 base year. Payments have been rebased and revised since the IPF prospective payment system was established, CMS noted. NABH is reviewing the proposed rule and will provide more details the week of April 22. The deadline for public comments is June 17. Federal Government Lost $26 Billion in Tax Revenue from Opioid Crisis Between 2000-2016 The federal government lost $26 billion in income tax revenue due to opioid misuse between 2000 and 2016, according to a new study in the journal Medical Care. Meanwhile, researchers found that opioid misuse cost state governments $11.8 billion, including $1.7 billion in lost sales tax revenue and $10.1 billion in lost income tax revenue. “By omitting lost tax revenue due to labor force exits, prior studies have missed an important component of opioid-related costs borne by state and federal governments,” the study’s authors wrote. The authors concluded that as more states and the federal government consider litigation for opioid-related damages, lost tax revenue reflects an important cost that could be recouped and allocated to opioid prevention and treatment programs. Joint Commission Releases Advisory on Drug Diversion and Impaired Healthcare Workers In an advisory released this week, the Joint Commission identified more than 20 patterns and trends that indicate drug diversion, the transfer of a legally prescribed controlled substance from the individual for whom it was prescribed to another person for illicit use. The advisory cited statistics from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the American Nurses Association (ANA) that estimate about 10 percent of U.S. healthcare workers are abusing drugs. Patterns and trends in this area include when: controlled substances are removed with no doctor’s orders, for patients not assigned to the nurse, or for recently discharged or transferred patients; product containers are compromised; and a verbal order for controlled substances is created but not verified by a prescriber. “Experts believe that only a fraction of those who are diverting drugs are ever caught, despite clear signals — such as abnormal behaviors, altered physical appearance, and poor job performance,” the advisory noted. “Direct observation is vital to detecting diversion and may be the only way to identify an impaired colleague.” Report Shows Psychiatrists Have a High Willingness and High Usage Rate for Telehealth Psychiatry is the only physician specialty that has both a high willingness and high usage rate for telehealth, according to a new report from American Well, a privately held telemedicine company based in Boston. The report, Telehealth Index: 2019 Physician Survey, found that more than three-fourths of U.S. hospitals are currently using or implementing a telehealth program. And, as telehealth becomes a more common practice nationwide, physicians are more willing to use the technology. The findings showed that a total of 69 percent of physicians said they would be willing to use telehealth, up from 57 percent in 2015. Psychiatrists fared well for both telehealth willingness and usage, with the study reporting that “every psychiatrist that is interested in practicing telehealth uses the technology.” Shatterproof Releases Summary of Collaboration with NQF on SUD Treatment Programs National not-for-profit organization Shatterproof has released NQF Quality Innovation: Measuring Quality of Care in Substance Use Disorder (SUD) Treatment Programs, a detailed report of its collaboration with the National Quality Forum (NQF). The summary highlights the process of developing performance and outcomes measures that addiction treatment programs will use for public reporting. Specifically, the 73-page report describes how the NQF convened an expert panel to “pressure test” Shatterproof’s proposed measure set by gathering multi-stakeholder expert input on the measures, additional measure concepts, and guidance on Shatterproof’s proposed implementation of the measure set in its providing rating system pilot and future national expansion. Shatterproof also released a measurement set that will undergo feasibility testing in several states before the measures are made final. The testing will begin this August. HRSA Accepting Applications for 2019 Graduate Psychology Education and Nurse Corps Programs The Health Resources and Services Administration (HRSA) is accepting applications for its Graduate Psychology Education (GPE) program and its Nurse Corps Scholarship Program (NCSP) until May. HRSA’s GPE program trains doctoral health psychology students, interns, and post-doctoral residents to provide integrated, interdisciplinary, behavioral health and substance use prevention and treatment services in high-need and high-demand areas. The program also supports faculty development of health service psychology. According to HRSA, there is about $18 million in funding for about 40 awards, and it will accept applications through May 7. The NCSP awards funds to students enrolled in a diploma, associate, baccalaureate, or graduate degree nursing program accept applications for this program if those students commit to serving in high-need, underserved communities. Scholarship support covers tuition, required feeds, other reasonable educational costs, and a monthly living stipend. HRSA will accept applications through May 21. IPF PEPPER Review Webinar Scheduled for April 24 A webinar to review the Inpatient Psychiatric Facility (IPF) PEPPER (version Q4FY18)—released on Friday, April 5—will be held on Wednesday, April 24 at 3 p.m. ET.   For questions or comments about CEO Update, please contact Jessica Zigmond.