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CEO Update | 46

HHS Assesses Impact of Parity in Large Group Employer-Sponsored Insurance Market The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 had a “significant positive impact” on the frequency of outpatient services for both mental health and substance use disorder (SUD), HHS reported this week in Assessing the Impact of Parity in the Large Group Employer-Sponsored Insurance Market. The 111-page report from the department’s assistant secretary for planning and evaluation office of disability, aging, and long-term care policy defined frequency as the average number of outpatient services used per service user. HHS concluded the magnitude of the law’s impact on SUD outpatient services was about 10 times larger than the magnitude for mental health outpatient services. Meanwhile, the analysis found that while the 2008 law had a positive and significant impact on average spending by the insurer (for both mental health and SUD outpatient services) and the enrollee (for SUD outpatient services), there was little impact on enrollee cost sharing and no impact on reimbursement rates to providers. The report also evaluated the findings in the context of the nation’s ongoing opioid crisis “The impact of MHPAEA on utilization of SUD outpatient services was not due to the OUD (opioid use disorder) epidemic,” the study said. “MHPAEA affected both OUD and other non-OUD SUD diagnosis groups in a similar way, increasing confidence that the changes observed at the point of parity implementation were due to parity and not to the OUD crisis,” it continued. “However, we did observe a greater magnitude of impact of MHPAEA for OUD outpatient services, suggesting that the influx of individuals with OUD diagnoses during the same timeframe as parity implementation interacted to some extent.” CMS Updates Data for the Inpatient Psychiatric Facility Quality Reporting Program The Centers for Medicare & Medicaid Services’ Hospital Compare website this week added six new measures to the Inpatient Psychiatric Facility Quality Reporting Program (IPFQRP). Hospital Compare reports information on about 100 quality measures for more than 4,000 hospitals nationwide, including Veterans Administration (VA) medical centers and Department of Defense (DoD) military hospitals. For questions about the IPFQRP, please e-mail the Hospital Inpatient Value, Incentives, and Quality Reporting Outreach and Education Support contract team through the Questions and Answers tool or call either of these toll-free numbers on weekdays between 8 a.m. and 8 p.m. ET: 844-472-4477, or 866-800-8765. VA Helps Veterans Manage Chronic Pain Without Opioids The Veterans Affairs (VA) Department’s new virtual reality program is helping the nation’s veterans manage chronic pain without opioids. The program provides veterans with different medical issues—including traumatic brain injury, spinal cord injury, stroke, amputations, or Amyotrophic Lateral Sclerosis (ALS)—with an alternative to using drugs such as opioids. Instead, veterans use a virtual reality headset or a large monitor screen to experience virtual scenic settings with music and narration. “Virtual reality is able to take the user someplace else they’d rather be,” Jamie Kaplan, a recreational therapist at the VA, said in a blog post. “For example, virtual games and activities can allow the wheelchair use to experience freedom from the limitations they face in everyday life.” […]
Commonwealth Fund Summarizes Care Programs for Patients with Complex Needs The Commonwealth Fund has released a Quick Reference Guide to Promising Care Models for Patients with Complex Needs, which summarizes the target populations and key features of 28 care models for adults with complex needs, including behavioral health. This guide was updated this year using the original version of the Quick Reference Guide that was developed in December 2016, data from a survey that the Center for Health Care Strategies conducted for the Better Care Playbook’s State Map, and literature searches. The Commonwealth Fund included models that targeted adults with complex needs; provided at least one element of patient-centered care; and had strong, moderate, or promising evidence on at least one outcome related to quality, utilization, or cost. Massachusetts to Help Test New Addiction Treatment Rating System Massachusetts will participate in a new rating system developed to measure the quality of addiction treatment programs, the Associated Press reported earlier this week. Health officials for the commonwealth said the rating system will use data from insurance claims, provider surveys, and consumer-experience surveys. The information will be made public to those seeking addiction treatment, as well as to public and private payers, states, and referral sources. The national not-for-profit organization Shatterproof is developing the rating system. If successful, the pilot program will be launched nationwide. Pew Research Center Reports Teens See Anxiety, Depression Among Their Peers Seven in 10 teens today see anxiety and depression as major problems among their peers, says a new report from the Pew Research Center. Anxiety and depression top the list of problems teens see among their peers, ahead of bullying, drug addiction, alcohol, poverty, teen pregnancy, and gangs, according to the survey of U.S. teens between the ages of 13 and 17. The study also noted that mental health concerns cross income boundaries, while teen pregnancy is seen as a much bigger problems by teens in lower-income households. Stanford Study Finds Opioids Less Effective for Patients on SSRI Antidepressants Patients who take the most common form of antidepressant and are given the most widely prescribed opioid experience less pain relief, according to a study this month from the Stanford University School of Medicine. Researchers say the finding could help address the nation’s opioid crisis because poorly managed pain may lead to opioid misuse. The study noted that as many as 1 in 6 American takes antidepressants, mostly selective serotonin reuptake inhibitors (SSRIs). Stanford’s research team found that SSRIs reduce the effectiveness of hydrocodone and codeine, which are often prescribed to patients who recently had surgery. “This research is part of our effort to find ways to combat the opioid epidemic,” Tina Hernandez-Boussard, Ph.D., M.P.H., associate professor of medicine, of biomedical data science, and of surgery at Stanford, said in a statement. “We’re very interested in identifying how we can reduce opioid exposure while still managing patients’ pain.” CMS Presents Podcast Series to Inform Broader Audience The Centers for Medicare & Medicaid Services (CMS) this week presented CMS: Beyond the Policy, a new podcast series intended to provide important, timely information to a broad audience. Through its […]
NEJM Article Reinforces Themes from NABH’s ‘Pathways to Care’ White Paper In a recent issue of The New England Journal of Medicine, authors of a study about the nation’s emergency departments echoed similar themes and recommendations that NABH provides in Pathways to Care: Treating Opioid and Substance Use Disorders. In their article “Emergency Departments—A 24/7/365 Option for Combating the Opioid Crisis,” Gail D’Onofrio, M.D. and Kathryn Hawk, M.D., M.H.S. of the Yale University School of Medicine, along with Ryan P. McCormack, M.D. of the New York University School of Medicine, recommend encouraging emergency departments to initiate buprenorphine as well as establish relationships with community treatment providers to expedite treatment referrals. Meanwhile, D’Onofrio notes that providing buprenorphine in the emergency department can reduce withdrawal within 20 minutes, thereby supporting adherence to a 60-90 minute benchmark for discharge in urgent care settings; buprenorphine can reduce violence in the emergency department that may result from the irritability of withdrawal; emergency departments that provide services/medications for opioid use disorder have not seen an influx of new patients, which helps alleviate concerns that patients might overuse the nation’s emergency departments as portals to treatment; and, lastly, that momentum is growing for hospitals to open clinics to continue emergency department-initiated medication treatment.   Vaping the Most Common Use of Any Tobacco-Like Product Among Adolescents in 2017 Vaping was the most common use of any tobacco-like product among adolescents in 2017, reflecting a rapid increase from a near-zero prevalence of vaping in 2011, according to a recent analysis from researchers at the University of Michigan and University of Minnesota. Data for the study came from Monitoring the Future, which surveys nationally representative independent samples of students in the 8th, 10th, and 12th grades each year. The study’s authors wrote about their findings in a recent letter to the editor of The New England Journal of Medicine. “The rapid entry of new vaping devices on the market, the latest example of which is the Juul, will require continual updates and modification of strategies to keep adolescents from vaping and its associated negative health effects,” the authors noted. Register Now for National Drug and Alcohol Facts Week There is still time to register for National Drug and Alcohol Facts Week, which connects students with scientists and other experts to counteract myths about drugs and alcohol. This year’s National Drug and Alcohol Facts Week will be held from Jan. 22 through Jan. 27, with a Chat Day scheduled for Jan. 24. Click here to learn more and register an event. NABH Immediate Past Board Chair Brent Turner Provides Year in Review for 2018 The SUPPORT for Patients and Communities Act, NABH’s Pathways to Care white paper, and the association’s rebrand were among the industry highlights and association improvements that 2018 Board Chair Brent Turner highlighted this week in his Year in Review for members. “We still have more work to do to repeal the IMD exclusion completely. At the same time, we should be proud of the work we have done individually and collectively on this issue since 2013,” wrote Turner, president of Acadia Healthcare. “Back then, some industry stakeholders […]