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More hope for the rural mentally ill

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There are major new efforts underway to make it easier for rural people to get access to mental-health services. People in many of America’s remote areas have long lacked such access. Even when they have it, many must deal with the stigma, particularly strong in rural areas, of mental illness. That stigma may be fading. And the increasing awareness of the tight links between mental and   behavioral health  and “physical health” is helping to focus more attention on mental-health services.

An article in governing.com discusses these changes. Among its observations:

“Despite all of the obstacles, a movement toward changing the balance of access and care in rural regions is showing signs of life. It flickered in 2008 with a federal mental health parity law that required insurers to offer behavioral health services on par with primary care ones. But that rule has not been rigorously enforced. Now, spurred by aspects of the Affordable Care Act and by technology that can bring virtual care to those who need it, rural mental health experts see the new wave of innovation as a means of bringing much-needed help to counties. “We’ve just recently finished what I like to think of as chapter one in the story of mental health in rural America,” says Ron Manderscheid, executive director of the National Association of County Behavioral Health and Developmental Disability Directors, referring to the 2008 law. “I want to focus on chapter two, which is ever-evolving.”

To read the article, please hit this link.


Deconstructing the healthcare part of Obama’s budget plan

 

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Electron microscope view of the Zika virus.

In HealthAffairs, Timothy Jost looks at  the healthcare elements of President Obama’s proposed budget for 2017, which includes “new initiatives to increase access to mental-health care, expand opioid-abuse treatment, fight antibiotic resistance, address the Zika virus threat and fund a ‘cancer moonshot.”’

He writes: “To control Medicare spending, the budget proposal would reduce the target growth rate for Medicare enforced by the Independent Payment Advisory Board  {IPAB} to 0.5 percentage points above per-capita GDP growth. It also contains a host of Medicare payment and delivery reform proposals.”

Regarding private insurance, one proposal “would attempt to curb surprise balance bills by out-of-network providers by requiring hospitals to take steps to match patients with in-network providers and requiring physicians who regularly provide services in a hospital to accept an appropriate in-network rate as payment in full.

“Another proposal would allow HHS {Department of Health and Human Services} to develop uniform definitions and principles for standardizing medical billing and making it more transparent. Self-insured non-federal governmental plans would be prohibited from opting out of various federal consumer protection laws, such as the Mental Health Parity Law.”

Mr. Jost notes that “{T} budget request of a president in his final year of office ….is unlikely to lead to enacted legislation. Congress in unlikely to expand the authority of the IPAB or increase funding for the Medicaid expansions. But many of the expenditures identified in the budget—for the risk adjustment, reinsurance, premium tax credit, and (subject to the court decision in House v. Burwell) cost-sharing reduction payment programs—are mandated by law and are unlikely to be changed by Congress.”

 


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