Partial hospitalization has long been a level of care offered by NABH members. In a recent NABH Annual Survey, more than half (56.8%) of all NABH members responding offered psychiatric partial hospitalization services for their communities, and more than a third (35%) offered partial hospital addiction services. Throughout the years, these NABH members have been a stable group of providers working hard to meet a community need. Patients may use partial hospitalization either as a transition from a hospital program or as an alternative to inpatient care.
NABH has been a major proponent and supporter of the Medicare partial hospitalization benefit since the inception of the benefit in the late 1980s. NABH worked with Congress in crafting the legislation, which became the basis for this benefit. The original intent of the benefit was to provide Medicare beneficiaries with an alternative to inpatient psychiatric care that would allow patients to move more quickly out of the hospital to a less intensive, “step-down” program or that would prevent the need for hospitalization. Before the advent of this benefit, Medicare’s mental health benefit structure was limited to inpatient psychiatric hospital care or outpatient, office-based visits. The partial hospitalization benefit created an important intermediate service between outpatient, office-based visits and inpatient psychiatric care.
The benefit continues to have a very important place as psychiatric reimbursement has moved to prospective payment and the importance of placing patients at the appropriate level of care has been re-emphasized. Without partial hospitalization as an option, one could imagine even more patients in overcrowded emergency departments. There is much evidence that emergency department care is an inefficient and very expensive way to care for patients experiencing a mental health crisis.
The current implementation of healthcare reform places ever-more emphasis on the importance of the care continuum. Essential to reform implementation is the creation of a system that makes it possible for patients to receive treatment at the most appropriate, cost-effective level with well-coordinated transition to the next level of care. We believe partial hospitalization is critical for helping the mental health system meet its goal of a robust continuum of services.