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Behavioral Health: Can Primary Care Help Meet the Growing Need?

Behavioral Health: Can Primary Care Help Meet the Growing Need?. Deanna Okrent Alliance for Health Reform www.allhealth.org May 4, 2012. Background. Current need in U. S. Is the need being met? How is behavioral health care financed? Policy questions.

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Behavioral Health: Can Primary Care Help Meet the Growing Need?

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  1. Behavioral Health: Can Primary Care Help Meet the Growing Need? Deanna Okrent Alliance for Health Reform www.allhealth.org May 4, 2012

  2. Background • Current need in U. S. • Is the need being met? • How is behavioral health care financed? • Policy questions

  3. Who needs behavioral health services? • Current need • Nearly half of all Americans will develop a mental illness in their lifetime • 27% of Americans will have a substance use disorder in their lifetimes • In 2009, mental health conditions were the fourth most common reason for hospital admission among children • In 2007, nearly 1/3 of adults and 1/5 of children had a behavioral health problem • Dually-eligible beneficiaries report the highest rates of mental illness • 50% among disabled beneficiaries • 20% among aged beneficiaries

  4. Is the need being met? • Behavioral health services have increased, but • 60% of adults with a mental health disorder do not receive treatment • In 2011, 17 % of adults had co-morbid mental health and medical conditions • 70% of children who need services do not receive treatment • The average time between onset and treatment of mental illness in children is nine years

  5. Mental Health Financing • Medicaid is the largest single source of payment • Covers over 25% of all expenditures • Covers a broad range of benefits • Medicare covers 7% • More limited range of benefits • Other public funds – state and local • Private insurance • Covers high % of population but less than 25% of expenditures

  6. Policy Questions • Integrating behavioral and physical health – do current models hold promise? • Are there enough providers now? For 2014 and later? • What is needed to help primary care fill the gap? • Can states meet the budgetary challenge in Medicaid programs? • How are CMS, HRSA, and SAMHSA supporting innovations as provided for in the health reform law? • Is parity being implemented per the Mental Health Parity and Addictions Equity Act? • Institutional care vs home health/outpatient care– what will the future hold?

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