WASHINGTON, March 18, 2019 — The National Association for Behavioral Healthcare (NABH) Board of Trustees on Monday approved a resolution that addresses unfair managed-care practices and recommends guiding principles for providers and payers to incorporate in contracts with managed care organizations (MCOs).
NABH’s provider systems are committed to ensuring patient access to behavioral healthcare treatment across the entire behavioral healthcare continuum, which includes inpatient, residential, partial hospitalization, intensive outpatient, outpatient, and recovery and support services. Too often, MCOs limit coverage to crisis stabilization or short-term, acute-care services for all levels of care because they use internally developed and/or proprietary and non-transparent, medical-necessity criteria.
“As our Access to Care resolution states, ‘Fair and appropriate coverage for behavioral healthcare services must ensure—not solely offer—access to the entire behavioral healthcare continuum,” said NABH Board Chair Pat Hammer, president and CEO of Oconomowoc, Wis.-based Rogers Behavioral Health. “For this to happen, fair and reasonable managed care contracts must include and apply generally accepted standards of professional practice.”
Articulated in clinical research and clinical specialty organization consensus statements, these generally accepted standards of care recognize that behavioral healthcare treatment is intended to:
- Prevent, diagnose, and/or treat behavioral health conditions;
- Promote age-appropriate growth and development;
- Minimize the progression of disability;
- Facilitate, maintain, and/or restore functional capacity; and
- Support long-term recovery.
NABH created a Managed Care Committee last fall to identify problems and propose solutions in managed care contracts. The Board of Trustees adopted the Managed Care Committee’s resolution at its Board meeting in Washington, D.C. on the first day of the association’s 2019 Annual Meeting.
“We hope this resolution and the guiding principles in it will help our members as they work with MCOs to develop contracts that are patient-centered,” said Mark Covall, NABH’s president and CEO. “This resolution is also significant because it is a major piece of our new Access to Care initiative that we’re launching today. Through this initiative, we will provide information and resources to help inform policymakers, regulators, payers, and patient advocates that only true access to care can lead to recovery.
NABH’s Access to Care initiative focuses on two major challenges: unjust managed care contracts and countless regulations, both of which often prevent behavioral healthcare providers from offering patients a full range of services.
Please visit www.nabh.org to read the resolution, watch NABH’s Access to Care video, and learn more. And follow us @NABHBehavioral and at #NABH19 for live updates from the 2019 NABH Annual Meeting.
The National Association for Behavioral Healthcare (NABH) advocates for behavioral healthcare and represents provider systems that are committed to delivering responsive, accountable, and clinically effective prevention, treatment, and care for children, adolescents, adults, and older adults with mental and substance use disorders. Its members are behavioral healthcare provider organizations that own or manage more than 1,000 specialty psychiatric hospitals, general hospital psychiatric and addiction treatment units and behavioral healthcare isions, residential treatment facilities, youth services organizations, and extensive outpatient networks. The association was founded in 1933.
SOURCE National Association for Behavioral Healthcare