CEO Update | 36

HRSA Releases Behavioral Health Workforce Projections About 276,400 people are expected to enter the behavioral health workforce during the five-year period between 2016 and 2021, HHS’ Health Resources and Services Administration (HRSA) estimates in a new analysis. The findings are part of HRSA’s Behavioral Health Workforce Projections that the agency compiled following a mandate from the 21^st Century Cures Act. In the analysis, HRSA provides national-level workforce estimates for the following occupations between 2016 and 2030: addiction counselors, marriage and family therapists, mental health and school counselors, psychiatric technicians and psychiatric aides, psychiatric nurse practitioners and psychiatric physician assistants, psychiatrists, psychologists, and social workers. According to a 2017 report from the Substance Abuse and Mental Health Services Administration (SAMHSA), nearly one in five adults in the United States—or about 44.7 million people—suffered from a mental illness in the last year, and in 2016 about 28.6 million people aged 12 and older used an illicit drug in the past 30 days. “Beyond the direct toll on individuals and families,” HRSA noted on its website, “mental illness and substance use disorders are well-established drivers of disability, mortality, and healthcare costs.” The HRSA analysis also included state-level behavioral health workforce estimates.   PwC Health Research Institute Previews Top Health Industry Issues for 2019 In its annual forecast, PwC Health Research Institute predicts that providers and payers that have served Medicaid patients will have a significant effect on the healthcare industry in the New Year. “In 2019 the health industry will see value lines created by innovative providers and payers that have figured out how to subsist—comfortably, thank you very much—by serving almost entirely Medicaid or cash-strapped patients,” the report noted. PwC’s 54-page analysis—The New Health Economy Comes of Age—also predicts that life sciences companies will market digital therapeutics and connected devices targeting atrial fibrillation, hemophilia, substance abuse, birth control, depression, diabetes, epilepsy and other conditions. “Once thought to operate outside the greater U.S. economy, the industry—with its byzantine payment system, complicated regulatory barriers and reliance on face-to-face interactions—is being disrupted,” the report noted. “Finally, there’s robust evidence that what PwC calls the New Health Economy is kicking into gear.” According to PwC’s analysis, 84 percent of Fortune 50 companies are involved with healthcare, and venture capital funding for digital health startups is projected to top $6.9 billion in 2018, reflecting a 230-percent increase from five years ago. Meanwhile, the report noted that “American consumers have told PwC’s Health Research Institute since 2013 that they’re “eager to embrace more convenient, digitally enabled and affordable care; finally, they’re finding it, with options that resemble the choices they have in other parts of their lives.”   CDC’s NSVR Reports on Drugs Most Frequently Used in Overdoses: 2011-2016 Fentanyl, heroin, hydrocodone, methadone, morphine, oxycodone, alprazolam, diazepam, cocaine, and methamphetamine were the 10 most frequently mentioned drugs among drug overdose deaths that noted at least one specific drug between 2011 and 2016, according to the Centers for Disease Control and Prevention’s (CDC) National Vital Statistics Report (NVSR). Oxycodone ranked first in 2011; heroin during 2012-2015; and fentanyl in 2015. During the study period, cocaine consistently ranked second or third, researchers found. The report’s conclusion said these findings highlight “the importance of complete and accurate reporting in the literal text on death certificates.” PCORI Board Approves $12.7 million for Mental Health Research Study The Patient-Centered Outcomes Research Institute (PCORI) Board of Governors this week approved $12.7 million to fund a study that will examine the effectiveness of different strategies to treat anxiety and depression in expectant and new mothers. Funding will go to researchers in Chapel Hill, N.C.; Chicago; and Toronto to study four different methods of providing treatment, in-person sessions with either a specialist provider or nurse, or the same sessions delivered via telemedicine. “Depression and anxiety symptoms pose a significant burden and lead to high costs among mothers worldwide,” PCORI noted in an announcement about the study. “Psychological treatments—also known as talk therapies, including behavioral, cognitive and interpersonal therapies—have a robust evidence base and are preferred by women and their families over pharmacological treatments,” the announcement continued. “Unfortunately, as few as one in five women can access these effective treatments due to a dearth of available specialists and barriers including cost, transportation, and access. There is therefore a need for widely accessible, low-cost, and innovative psychological treatments for depression and anxiety during pregnancy and postpartum.” Click here to learn about the project’s details. U.S. Preventive Services Task Force Seeks Comments on Opioid Interventions The U.S. Preventive Services Task Force (USPSTF) this week opened the public comment period for its draft research plan on interventions to prevent opioid use disorder. The USPSTF notes clearly that the plan is in draft form and has been distributed for the sole purpose of gaining feedback. The task force will accept public comments through Wednesday, Jan. 16, 2019 at 8 p.m. ET. CMMI Posts Fact Sheet on Integrated Care for Kids and Maternal Opioid Misuse Models The Center for Medicare and Medicaid Innovation (Innovation Center) has posted a fact sheet on its Integrated Care for Kids (InCK) and Maternal Opioid Misuse, or MOM, Models designed to improve care delivery and reduce expenditures for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries affected by the nation’s opioid crisis. “By catalyzing state-driven care transformation and aligning financial incentives, both models aim to improve health outcomes and address fragmentation of care for affected beneficiaries,” the Innovation Center noted. “Ultimately, the InCK and MOM models aim to enable better coordination of clinical care and the integration of other services critical for health, wellbeing, and recovery.” Manatt, AMA & Pennsylvania Medical Society Release Report on Practices to End Opioid Crisis Manatt Health, the American Medical Association (AMA), and the Pennsylvania Medical Society this week released a report that examines what Pennsylvania has accomplished in the areas of substance use disorder treatment, pain management, and harm reduction to combat the opioid crisis. The report focuses on the work of two agencies—the Pennsylvania Medicaid agency and the Pennsylvania Insurance Department—and highlights in particular Pennsylvania’s broad support for Medication Assisted Treatment (MAT), parity law enforcement, and comprehensive naloxone access. Researchers also included recommendations on how Pennsylvania can “build on its successes, including expanding efforts in emergency departments and law enforcement to link patients to high-quality care, and requiring insurers to enhance access to non-opioid care so that patients have alternative treatments as opioid prescriptions are reduced.” CHCS and ACAP Release Report on Social Determinants of Health via Medicaid Managed Care The Center for Health Care Strategies (CHCS) and the Association for Community Affiliated Plans (ACAP) this week released findings of a nationwide review of Medicaid managed care contracts and section 1115 demonstrations to identify common themes in state approaches to incentivizing and requiring social determinant of health-related activities (SDOH). Addressing Social Determinants of Health via Medicaid Managed Care Contracts and Section 1115 Demonstrations includes five specific policy recommendations from CHCS to support SDOH activities: make  it easier for vulnerable populations to access needed health services; enhance agency collaboration at the federal level; provide guidance on addressing SDOH through managed care; approve section 1115 demonstrations that test strategies to address SDOH; and support outcomes-based payment for SDOH interventions.   Associations Among Motor Activity, Sleep, Energy & Mood Could Suggest New Focus for Depression Treatment Instability in activity and sleep systems could lead to mood changes—which could suggest new approaches for depression treatment, according to new findings published online in the journal JAMA Psychiatry. Current theories of depression suggest that sleep problems, low energy, and low activity levels result from depressed mood, but this new study that examines these factors among people with bipolar disorder or depression suggest the opposite may be true, the National Institute of Mental Health noted in its announcement about the study. Researchers “discovered a unidirectional relationship between motor activity and mood, suggesting that motor activity affects subsequent mood, but that mood does not affect subsequent motor activity and sleep systems could lead to mood changes,” the NIH posting said.   Register Now for the 2019 NABH Annual Meeting Please visit NABH’s Annual Meeting homepage today to register and reserve your hotel room for the 2019 NABH Annual Meeting — Behavioral Healthcare: Improving Coordination, Collaboration, Integration. Beginning next week, NABH will send periodic NABH Annual Meeting Alerts to keep meeting attendees informed about the latest speaker and programming information. And in January, NABH will post the 2019 Annual Meeting preliminary program on the NABH website. This online preliminary program will replace the previous printed preliminary program. All meeting attendees will receive a final printed program on site at the Annual Meeting. We look forward to seeing you at the Mandarin Oriental Washington, D.C. from March 18-20, 2019   For questions or comments about CEO Update, please contact Jessica Zigmond.