MPA's Progress Prepares for Health Care Reform

By Steven M. Vincent, Ph.D., President Elect

For at least two decades we have heard nearly constant discussion about health care reform, to the point that many people have come to doubt that anything substantive is going to happen.   However, among policy makers, pundits and progressive thinkers, health care reform is now seen as inevitable.  In March I wrote about the APA State Leadership Conference which took place in Washington, D.C. from March 9-12 with the theme of “Countdown to Health Care Reform.”  Seventy-five State, Provincial and Territorial Associations, and APA divisions, focused their attention on preparing psychology for reform, with an emphasis on ensuring that our profession will have an important and powerful role in this process.  MPA’s own annual convention on April 5 and 6 took a similar theme, “Surviving and Thriving:  Psychology in the Era of Health Care Reform.”  With the conclusion of the Minnesota State Legislature’s 2013 session on Monday, May 20, MPA can claim real progress preparing the way for psychology’s place in health care reform.

MPA’s Bills

At the beginning of the legislative session, MPA found authors to introduce two bills.  The first of these added to psychologists as professionals who can provide consultation to primary care providers and obtain reimbursement from Medical Assistance if the patient is covered by MA.   This bill passed the legislature with this language: “Medical Assistance covers consultation provided by a psychiatrist, a psychologist, or an advanced practice registered nurse certified in psychiatric mental health via telephone, e-mail, facsimile, or other means of communication to primary care providers, including pediatricians.”   Whenever health care reform is discussed, a central tenet is the integration of mental health/substance abuse services with primary care.  MPA’s success in getting this bill passed provides a framework for psychologists to consult with primary care providers and receive compensation from Medical Assistance.   This structure can be a model for consultation, integration and compensation by other payers as well.  Passage of this bill is the culmination of five years work at the legislature and the efforts of many MPA members, but special kudos must go to Dr. Trisha Stark, MPA’s legislature chair and consultant, and to our lobbyist, Patrick Lobejko.

MPA’s second bill called for increasing MA reimbursement rates by 23% for all psychologists, an increase that was given five years ago to psychiatrists, advanced practice nurses, community mental health centers and hospitals that are essential community providers.  This bill is also a five year legislative endeavor of MPA and it finally got into initial budget proposals this year.  It did not, however, make it into the final budget bills.  Nevertheless, beginning on September 1, 2014, MA payment rates for all services, including mental health services will be increased by 5%.

Success and progress on MPA’s bills is an indication that psychology is increasingly seen as integral to the health care system, and MPA’s consultation reimbursement bill clearly fosters integration of psychology and primary care.  Such integration is the future of both psychology as a profession and of health care in general.  To the extent that psychologists develop the skills and the relationships to provide such consultation, we will play an essential and valued role in the Triple Aim (a widely accepted construct for the goals of the United States’ health care system):  1) improve the patient experience of both quality and service; 2) improve the health of the entire population; and 3) reduce the total cost of care.

Other Legislative News

In addition to dealing with MPA’s bills, the state legislature acted on at least twenty other measures that are likely of interest to many psychologists.   For example, all new licensees of the Board of Psychology will go through criminal background checks and be fingerprinted.  By 2017, the Board is required to have a plan to extend this to all licensees.  Please keep your eyes and ears open for more information on this and the other changes of interest. MPA will use the Minnesota Psychologist, email alerts, division list serves and other forms of communication to inform members about legislative, regulatory and political activity.

What to Do Next

As we move into summer, many of us hope the pace of life will slow a bit, and legislators are particularly eager for a break from the demands of the legislative session.  Nonetheless, summer and early fall are prime times for planning and developing relationships with legislators.  Please make the time to inform yourself and please consider making contact with your legislators.  Let them know you are paying attention and are available to answer their questions or give them a perspective from the mental health provider and consumer community.  Recently the CDC released a new report on children’s mental health. As psychologists, we will all find this interesting, and this is useful information to share with patients, primary care providers and politicians, as we demonstrate the necessity of psychological science and service in developing healthy communities and caring for individuals.   Our role as citizens calls us to be engaged and our training as psychologists gives us valuable knowledge that can help our communities, state and nation move forward.

Steven M. Vincent, Ph.D., L.P., is the Director of Behavioral Health Services, CentraCare Health System ([email protected]).  Dr. Vincent is the current president-elect of MPA, having served two terms on the Governing Council from 2003 to 2009, and as a Legislative Committee Chair from 2004-2012.   Steve was also on the Governing Council of the American Hospital Association Section on Psychiatric and Substance Abuse services from 2010 through 2012.  He is the founding chair of the Minnesota Hospital Associations Mental Health Task Force.

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