Psychiatric News January 7, 2005
Volume 40 Number 1
© 2005 American Psychiatric Association
p. 21
Prescriptions for a Better Health System
The report "Financing the Care of Individuals With Serious Mental
Illness" offers the following advocacy recommendations to forge a system
in which people with serious mental illness have access to the care they
need.
On the most global level, advocates should work to achieve parity of health
insurance benefits for all psychiatric patients under all payers. Other ideas
for advocacy include these:
- Revocation of the institutions of mental disease exclusion under Medicaid
in order to better support state and county hospitals and staunch the flow of
seriously ill patients into nursing homes.
- Reasonable Medicaid and Medicare rate structures for the reimbursement of
outpatient, clinic, and rehabilitative services in order to support an ample
and high quality system of care.
- Timely Medicare and Medicaid eligibility determination and reinstatement,
beginning before release from long-term hospitalization or prison.
- Responsible pharmacy benefit management that promotes good patient
outcomes.
- Clinical quality management requirements in fee-for-service Medicaid and
for all publicly funded services.
- Collaborative purchasing among federal, state, and private agencies to
create comprehensive benefit packages.
- Higher income and asset limits and the inclusion of optional Medicaid
benefits, such as psychosocial rehabilitation and targeted case management for
states pursuing benefit expansions under Health Insurance Flexibility Act
waivers, along with graduated mechanisms for cost sharing such as premiums,
copayments, and fiscal management structures that help assure appropriate
service use.
- Alternative reimbursement structures to support progressive and efficient
clinical practice and adequate ambulatory alternatives to institutional
care.
The report also made recommendations concerning regulations and services
for people with disabilities.
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