Introduction
There are several issues that have been facing the healthcare industry for a long period of time. The behavioral healthcare system is struggling with numerous current issues that need to be addressed. Some of the issues include but not limited to; mental health services within the healthcare delivery system, the primary care providers’ role in the mental healthcare delivery system, current market strategies for mental health services, Staffing and credentialing issues for behavioral healthcare professionals, staffing and credentialing issues, changes in reimbursement for behavioral healthcare, and regulation and accreditation issues.
The report by the National Health Mental Health Information Center of Mental Health Services argues that behavioral healthcare is very important in the healthcare delivery system. This is because it will serve to improve the healthcare provision in general. This brings out the need for the development of appropriate healthcare facilities. Another major concern for the healthcare delivery system is the provision of consumer support in the behavioral healthcare. According to research findings, the primary healthcare service providers are extremely important to healthcare delivery system (Bazelon Center for Mental Health Law, n.d.). Furthermore, the primary healthcare service providers are extremely important to healthcare delivery system since they offer a general focus on patient’s health and wellness.
Research findings by Hinkle (2008) reveal that the current market strategy for mental health services has been an issue which the service providers have not failed to consider. Furthermore, staffing and credentialing issues for behavioral healthcare professionals have also been identified as very crucial. Other important current issues have been widely elaborated.
The purpose of this research paper is to explore the existing literature on the current issues regarding behavioral healthcare system. The articles covering the various issues are critically evaluated and comparisons as well as contrasts draw. Professional view of the articles is also provided.
Literature Review
Behavioral Healthcare and Its Role in the Healthcare Delivery Systems
Mental Health Services within the Healthcare Delivery System
According to the National Mental Health Information Center of Mental Health Services (CMHS), behavioral healthcare is very crucial in the healthcare delivery system (n.d.). Its major role is to serve the community to improve and enhance the quality and range of healthcare services. Behavioral healthcare is also important to communities and to mental health patient families.
One of the most important roles of behavioral healthcare within the healthcare delivery system is the provision of community support. Typically, community support programs (CSP) are run by the Federal system. These support programs are very important to the behavioral healthcare delivery system (CMHS, n.d.).
Furthermore, the National Mental Health Information Center of Mental Health Services identifies consumer/survivor support as another important part in behavioral healthcare and its role in the healthcare system (n.d.). Support is available for planning, policy formulation, and evaluation of different mental health services. The protection and advocacy for mental healthcare patients is also an important factor offered by the behavioral healthcare system.
The primary care providers’ role in the mental healthcare delivery system
According to research findings by Bazelon Center for Mental Health Law, the primary healthcare service providers are extremely important to healthcare delivery system (n.d.). They offer an overall focus on patient health and wellness. More importantly, physicians play a very crucial role in handling mental health disorders in patients. Primary care physicians are important when it comes to care for patients with severe mental illness.
Primary healthcare providers have a very important role in the behavioral healthcare when it comes to its role in the healthcare delivery system. Proper training is therefore very important for these physicians (Bazelon Center for Mental Health Law, n.d.). It is said that the primary healthcare provider offer treatment to more than half of the mental health community. However, statistics indicate that more than half of the behavioral healthcare problems are not properly identified in the primary care clinics, leading to under-diagnosed disorders.
The Bazelon Center for Mental Health Law found that funding is very crucial in order for primary care providers to be able to offer a behavioral healthcare specialist within their practice (n.d.). Therefore, a healthcare policy that ensures financial reimbursement would help to remove some of these barriers. When it comes to behavioral healthcare within the healthcare delivery system, it must be understood that primary care physicians cannot meet and address all the needs of the patients. The hindrances to the different types of consultations need to be removed, and a way possible could be as simple as placing a psychiatric consult line that the primary care provider can access (Bazelon Center for Mental Health Law, n.d.).
The most relevant article among the two from a professional point of view
The primary healthcare provider’s role in behavioral health can be considered as the most relevant article. Patients are able to see their healthcare providers on a regular basis more than any other type of healthcare professional. When it comes to behavioral healthcare in the healthcare delivery system, a primary care physician can have a great impact on how their patients are treated. If the physicians are treated properly and in a timely manner, they can offer great services. Therefore, they need to have access to appropriate resources that will help them provide the best managed healthcare possible.
Current Market Strategies for Mental Health Services
In the current world of technology and civilization, market strategies for various services have been brought into focus. This is in an attempt by the service providers to secure and manage the market for the services they offer. According to research findings by Hinkle (2008), the current market strategy for mental health services has been an issue which the service providers have not failed to consider. These services will go a long way in enhancing their efficiency and hence effective service provision (Hinkle, 2008). Moreover, a strategic plan of action on the best positioning and distribution of mental health services institutions is of crucial importance. This is particularly in consideration of the current trend of competition and increased legal requirements for the running of some technical businesses like the provision of mental health services (Hinkle, 2008). In this context, therefore, various articles have been written to address the strategic markets for health service providers, where they depict the rationale necessary for the marketing of health services.
In their article titled “Strategic Market Positions for Mental health Services”, David and Linda discuss the issue of strategic positioning of health services (2008). The key considerations during the positioning of mental health service institutions include the size of the population within the selected area, the availability of social and infrastructural networks and the level of civilization among the people in the selected area (David & Linda, 2008). Furthermore, the article addresses the issue of the level of competition expected in the position selected for offering the mental health services in which the mental health provider has to consider the existing similar services in the surrounding. On this basis therefore, the health service provider should consider the current increasing competition levels among various individuals. The existence of institutions offering similar services will definitely present tough competition. This is the case, according to David and Linda, because the provider should consider not providing similar services due to the increased global demand for the services as a result of high technological advancement and civilization among the various communities within the society (2008).
Another article that addresses the issue of strategic marketing for mental healthcare services is called “Developmental Marketing Strategies for Community Mental Health” by Mark Hayes. In his article, Hayes addresses the factors that the community health providers have to consider in order to ensure effective marketing of their services (1984). The techniques that health providers for mental disorders should consider and apply so as to ensure that they give their services most efficiently are also discussed in the article.
Most researchers have put a lot of emphasize on the application of sophisticated and the most efficient equipments necessary for the improvement of the services provided. Considering the current technological world, Hinkle stresses the use of very efficient clinical equipments within the provision of mental health services (2008). This will facilitate effective competition within the current highly competitive world.
Generally, the two articles are closely related in the sense that the key concept stressed in the two books for health service providers is the way they can attain an optimum marketable position within the society as far as the provision of mental health services is concerned. Furthermore, this linkage between the two articles indicates a common perception to mental health services by both the service providers and their clients. According to Hinkle (2008), the need for a strategic plan by the mental health service providers is essential so as to achieve their goals.
As it has emerged, a good marketing plan for mental health provision is necessary since a consideration will be given to the available competitors, the availability of clients, and the use of sophisticated clinical equipments. These considerations will go a long in ensuring the pursuit and achievement of the set goals and objectives.
Staffing and Credentialing Issues for Behavioral Healthcare Professionals
Choosing a treatment center
Credentials are very important factors when it comes to behavioral health treatment centers and making sure a patient chooses one that fits their needs. This can prove to be a very daunting task for a patient. So many factors are important in behavioral health centers. Some of them include qualifications, official recognition, quality, insurance, and staffing. All these considerations are very important in choosing a treatment center.
Even if there is not enough time to consider such important issues, there are some key recommendations for patients and their families to look into. A patient or their family member should start by getting names. This can be easily done by obtaining a recommendation from a physician or even a behavioral health professional that they know and trust. Simply asking these professionals where they would send their loved one can go a long way in choosing the right treatment center. Other recommendations for patients could be to consult different referral hotlines for professional organizations. These can include member organization lists and credentialed professionals that have specialties in the area of the patient’s concern. One should keep in mind that the costs, insurance issues or other barriers may prevent a patient from admission to one facility, yet not another. Another simple step can be to contact the behavioral health insurance carrier and ask them for the patient/loved ones approved treatment centers.
Staffing and Credentialing Issues
Once the patient and family have narrowed their search of treatment centers down, the next important step is to ask questions. According to the Joint Commission on Behavioral Healthcare, finding proper professional credentials and expertise in the staff is very important for a behavioral health patient. There are a number of categories of professionals to consider when choosing staffing and credential issues for behavioral healthcare professionals.
Firstly, we have the psychiatrists who are medical doctors. They are also able to prescribe medication to their patients as well as provide psychotherapeutic services. Secondly, the addiction medicine professionals play a significant role in the selection of behavioral health professionals. They undergo specialized training before they can be allowed to operate in a specific field. Psychologists are the third category and are behavioral health professionals who have obtained a doctoral degree and are able to help a patient in psychological tests and other diagnostic assessments. The last group is the Certified Addiction Professional. This refers to a behavioral health professional whose specialty is in counseling and assessment of addictive diseases. Usually holds an associate degree and has fulfilled their states guidelines in order to gain a certification.
Contacting the state’s licensing board’s website by way of the National Practitioner Data Bank is another option for finding information on accreditation. Here a patient or family member can find out about malpractice suits as well as licensing sanctions. Moreover, patients and members of the family can also find information on staffing and credentialing issues for behavioral healthcare professionals is to search the Joint Commission agency’s website. The patient and family member can gain very important access to information such as accreditation programs, certification programs, standards, patient safety, and public policy reports. The Joint Commission has been in service since 1969 and has been providing evaluations for organizations that are providing mental health, chemical dependency, mental retardation, developmental disabilities services and other psychological services.
According to the website, they have been offering the services of behavioral healthcare since 1972 as far as accreditation is concerned. By being an informed consumer, there is a much better outcome and satisfactions for all parties involved.
Analysis of which article is more relevant from a professional point of view
Both of these articles are extremely helpful when it comes to staffing and credentialing issues for behavioral health care professionals. Value Options is a little more geared towards the consumer to help provide information on selecting the proper behavioral health facility that can suit their individual needs. The information found on the Joint Commission’s Web site can be just as valuable for patients as well as the professionals. They provide a wealth of information in regards to the usage of medications. This can be very helpful to behavioral health patients when establishing a patient/doctor relationship. It can also help to inform both patients and physicians of which types of treatment options are the best. The two sites provide clear behavioral health information. However, the content of the two articles are distinct.
Changes in Reimbursement for Behavioral Healthcare
Medical executives from different US healthcare department argue that government healthcare expenses are increasing. According to Stoil, this is due to the fact that the federal administration spends too much on Medicaid, a US healthcare plan meant to assist persons who cannot afford healthcare (2006). It is noted that the government monetary contribution amounts to a huge percentage of total Medicaid expenditure. In fact, it may increase in case the projected increase of Medicaid expenditure remains unchallenged. US government agenda on behavioral healthcare were habitually interpreted as state objective of influencing the healthcare which the poor persons get (Stoil, 2006). Stoil in his article further notes that this is because in the past, the government’s major expenditure on behavioral healthcare was directed to asylums and government healthcare entities (2006). However, this has changed overtime with the government investing more on community progress institutions and other non-income generating entities.
Moreover, healthcare institutions including rural and federal establishments have raised concerns that obtaining compensation from Medicaid has proved difficult to them thus putting the health of the patients at risk. According to HRSA (2005), the concerns were responded by seeking statutory requirements of Medicaid and was finally settled that it is Medicaid’s obligation to reimburse the rural and federal healthcare institutions and the persons to be compensated include; doctors, nurses and any other clinical social employee. Additionally, refund must be strictly on expenses incurred in line of duty as stipulated by the constitution. This is because concern of compensating certain duties on which were not within the scope of Medicaid strategies was raised. The worry was solved with reference to statutory boundaries that explain the extent to which practitioners are to be compensated.
Recently, Medicaid reimbursement on behavioral healthcare entities has been restricted by the government. As a setback, Medicaid assistance to healthcare entities such as FQHC and HRC is threatened since it may fail to satisfy its legislative obligation (HRSA, 2005). It is renowned that Medicaid does not define the services to be rendered by medical employees but instead it recognizes the medical staffs based on their medical qualification. In addition, reimbursement is done based on the work done within the scope of their profession as stipulated in the statute law.
Analysis of the articles
Medicaid fiscal service is outshining the rural grant bodies due to the support it gets from the government. In light of this fact, Stoil notes that Medicaid reimbursement of healthcare services is projected to increase thus effectively satisfying its legislative requirements (2006). In addition, government reimbursement has recently shifted from state owned institutions to other healthcare bodies such as societal and non-income generating entities. Congress has restricted Medicaid fiscal reimbursement to healthcare services consequently limiting its operations. This has raised concern among medical practitioners since they encounter tribulations in receiving compensations (HRSA, 2005). Furthermore, concerns on the scope of work to be compensated have proven to be controversial. This is in reference to Medicaid limited mandate to rule over the matter.
Comparing and Contrasting, including personal opinion
The first article by Stoil talks about the fiscal capacity of Medicaid with potential increase in future financial service. Furthermore, it explains the shift of Medicaid operations from governmental to non-state healthcare institutions. Contrary to this, the second article dwells on the concerns raised by the practitioners with respect to their reimbursements. Concerns such as the scope of work to be compensated have proven to be controversial with Medicaid finding it difficult to solve the issue. This is because of government restrictions on Medicaid compensations on behavioral healthcare services. Professionally, I would go by the second article because it handles professionally raised concerns on the scope of reimbursements. Moreover, it talks about the reasons behind the concerns and points out persons who are responsible for the issues. In fact, it explains the changes that have affected reimbursement of professionals resulting from government restrictions, as opposed to the first article which dwells on Medicaid’s current and future fiscal aspects.
Regulation and Accreditation Issues
There are more than 1,300 members of the National Council for Community Behavioral Health Care or similar organizations across the United States. According to Rosenberg (2007), most of these are accredited by the Joint Commission or CARF. However, there are some members who according to their states operation requirements, have not taken the accreditation route. When it comes to the choice of gaining the proper accreditation for a behavioral health facility, there are some factors that tend to go against its favor: initial and yearly fees in order to obtain this accreditation; the administrative and clinical departmental initiatives, the ongoing committee meetings, as well as the resultant documentation which requires much investments of the facility staff time, as well as compliance with the life safety codes that are seemly beyond the local requirements (Rosenberg, 2007).
As reported by Rosenberg, to some prestigious facilities, having the proper accreditation is part of their success. However, for a community based mental health facility or an addictions service agency that is state run there are controlling factors. Most often these facilities are under the stringent regional authority or a not-for-profit organization that is run by a board of directors. These state authorities also continue to oversee as well as monitor the behavioral health organizations with a good degree of scrutiny as well as an involvement that is unheard of in any other similar or different part of the health care industry.
According to Ramsay (2008), behavioral healthcare facilities as well as the administrative leaders in psychiatric hospitals have faced many challenges. Furthermore, regulations and accreditations have been a challenge as well to behavioral health facilities. In the U.S. today there are many arrays of regulations- from EMTALA and HIPPA, to state and government regulations and accreditations. Just like any other hospital, a behavioral health care clinic or facility is subject to rules, and inspections from scores of agencies (Ramsay, 2008).
Main points from both articles
In the first article by Ramsay, the main points covered are accreditation issues faced in the behavioral healthcare industry. Many clinics feel a greater need to gain the proper accreditation for their patients. Whereas other behavioral health care facilities find that their state and board provide enough governing for their facilities. Both are able to provide adequate care for their patients and in a proper manner that is professional and current with accreditation standards.
In the second article the main point(s) are those of regulations and the time involved to maintain them. Regulations are in place to make sure that patient privacy is insured, as required by the HIPPA Act.
Comparing and contrasting, including my point of view
The first article seems to deal with the hassle of maintaining accreditation. Many facilities seem to understand the importance of accreditation, while others seem to think that their state has enough when it comes to how their facility is run. In the second article, the importance of regulation is explored. Regulations are in place to protect not only the behavioral health care facility, but the patient as well. Professionally, I would go with the second article. It deals with the importance of regulations in the behavioral health care facility as well as technology. In behavioral health care today, technology and regulation go hand in hand. Whether this involves understanding the multiple regulatory, funding system to electronic medical records-“psychiatric hospital administrators have to be knowledgeable and current in their understanding of a complicated and often labyrinthine array of regulatory, operational, and technologic issues” (Ramsay, 2008).
Regardless of all these regulations and accreditation issues faced by the behavioral health care administrations- they need to remain compassionate with their patients and provide the best possible care for them. Rules, regulations, accreditations are in place for their protection as well as the patients.
Conclusion
The research paper has elaborately analyzed the articles on the current issues in behavioral healthcare system. The research paper has clearly indicated the main trends and issues faced by today’s behavioral healthcare as well as those that are expected to be experienced in the near future. From the analysis, the behavioral healthcare system is faced with several current issues that need to be addressed if the future of healthcare system is to be rescued. Some of the issues that have been discussed include; mental health services within the healthcare delivery system, the primary care providers’ role in the mental healthcare delivery system, current market strategies for mental health services, Staffing and credentialing issues for behavioral healthcare professionals, staffing and credentialing issues, changes in reimbursement for behavioral healthcare, and regulation and accreditation issues. These issues, according to the above findings, indicate that they are closely related in one way or another.
As observed by the National Health Mental Health Information Center of Mental Health Services, the behavioral healthcare is very important in the healthcare delivery system. This is due to the fact that it serves to improve the general healthcare provision. This brings out the need for the development of appropriate healthcare facilities and services. Another major concern for the healthcare delivery system is the provision of consumer support in the behavioral healthcare. The Bazelon Center for Mental Health Law found that funding is very crucial in order for primary care providers to be able to offer a behavioral healthcare specialist within their practice (n.d.). Therefore, a healthcare policy that ensures financial reimbursement would help to remove some of these barriers. The other current issues in the healthcare system can be alleviated by addressing the problems identified by the various researchers. Given a chance, therefore, I would conduct research on major issues facing the behavioral healthcare professionals because they directly influence the quality of treatment services to the clients.
References
Bazelon Center for Mental Health Law, (n.d.). Primary Care Providers’ Role in Mental Health. Web.
David, A. & Linda, L. (Feb. 08, 2008). Strategic Market Positions for Mental health Services. Springer New York, 15 (1), 5-9.
Hayes, M. (1984). Developmental Marketing Strategies for Community Mental Health. Health Marketing Quarterly, 1 (2), 57-66
HRSA, (2005). Policy information notice 04-05: Medicaid reimbursement for behavioral health services. Web.
Hinkle, A. (2008). A Marketing Strategy for Consultation and Education Services. Springer New York, 9 (2), 10-12
Joint Commission, (2010). Facts about behavioral health care accreditation. Web.
National Mental Health Information Center of Mental Health Services, (n.d.). Web.
Ramsay, D., MPP, OTR, (2008). Changing times by a constant mission. Web.
Rosenberg, L., MSW, (2007). Why not accreditation? Web.
Stoil, M. (2006). When Medicaid paid bills: behavioral healthcare have suffered as Medicaid has become the dominant public-sector payer. Behavioral healthcare management. Web.
Value Options, (2010). ABCs of Mental Health Care. Web.