Businesses are upping their investments to treat mental health patients in Mass.
PHOTO/Matt VOLPINI
Charles J. Faris, president and CEO of Spectrum Health Systems of Worcester, signs the final beam for the frame of his organization’s new 100-bed
residential treatment facility in Westborough.
A few years ago, mental health funding in Massachusetts was under siege as Gov. Deval Patrick struggled to produce a balanced budget as the Great Recession limited revenue.
The tide has turned, and the Massachusetts Chapter of the National Alliance on Mental Illness (NAMI) celebrated when lawmakers increased mental health spending in the fiscal 2015 budget by $32.1 million over fiscal 2014, a rise of just under five percent.
But some of the money comes from one-time revenue sources, according to a NAMI analysis, making the future uncertain.
Meanwhile, the private sector is stepping up to the plate. In Central Massachusetts, a number of recent investments points to heightened interest in serving people who need mental health services.
Spectrum CEO: Mental health business more appealing
“Demand has continued to rise, and I think, with the advent of expansion of insurance … that has made it a little more appealing,” said Charles J. Faris, president and CEO of Spectrum Health Systems Inc. of Worcester.
Spectrum, which specializes in the addiction-treatment side of mental health, celebrated the completion of a new 100-bed residential treatment facility in Westborough this month. While Spectrum's operating margins are growing, Faris said those margins are as tight as ever, holding at around 3 percent in a good year. That's largely because Spectrum relies heavily on reimbursement from public payers for its revenue, and those payments are relatively low next to reimbursements for other health care services.
Companies that collect payments from private insurers at a greater clip have also introduced new programs and expanded services in the last year to treat patients.
Among them are Tenet Health, which owns St. Vincent Hospital and MetroWest Medical Center, Worcester-based insurer Fallon Health and the Bay State's largest insurer, Blue Cross Blue Shield of Massachusetts.
Reducing spending is part of the equation
While officials with the companies cite a desire to meet the health needs of the area as the impetus for boosting mental health services, it's clear that these investments also make good business sense.
In some cases, offering effective services for mental health patients may help reduce overall health care spending and free up emergency room resources while improving care for the mentally ill. So says Dr. Jeff Simmons, medical director for behavioral health at Blue Cross.
In August, Blue Cross announced a suite of new insurance products designed for people who need mental health and substance abuse treatment services. They include new social media tools that provide support to patients remotely, care management services and one-on-one coaching to help mental health patients who suffer from other serious medical conditions.
Simmons said the new products aren't directly related to federal or state health care reform, which broadened coverage for the formerly uninsured while, on a state level, requiring insurers and providers to reduce cost growth based on annual benchmarks established by the Massachusetts Health Policy Commission.
But the investments come at a time when health care reform is “the air we breathe,” Simmons said. He noted that behavioral health patients, on average, spend substantially more on all their medical care after being treated for mental illness or addiction, and that's an important relationship to understand, given the mandate to reduce health care spending.
“We've been trying for the last 10 years to understand that, so we can position the care people need, when and where they need it,” Simmons said.
Laws foster more services
Analyses conducted by Fallon Health have also shown that spending rises significantly once a patient is diagnosed with a behavioral condition, according to Dr. Matt Collins, Fallon's senior medical director for medical affairs.
The insurer recently launched a federally-designed pilot program, Fallon Total Care, which provides health care management for patients eligible for both Medicare and Medicaid coverage. Most of them have behavioral health conditions, Collins noted.
Collins believes state and federal laws have made the health care community more responsive to the needs of the mentally ill. The federal Mental Health Parity and Addiction Equity Act of 2008 requires insurers to make financial requirements and treatment limits no more restrictive than those for other medical conditions.
In Massachusetts, a bill was passed in July that requires insurers to provide coverage for up to 14 days of in-patient addiction treatment while removing prior-authorization requirements for outpatient services.
Access to all types of in-patient behavioral health services is an ongoing obstacle, Collins noted, as the number of available beds in Massachusetts has historically fallen short of needs. But in Central Massachusetts, the census is climbing.
Boosting the bed census
In addition to Spectrum's new addiction treatment facility in Westborough, Tenet-owned St. Vincent Hospital in Worcester, and MetroWest Medical Center in Natick, have been revamped to keep pace with demand.
St. Vincent's behavioral health care unit was moved from the Vernon Hill campus and reopened at the main hospital on Summer Street in April 2013. The unit is not larger, but features better technology and closer proximity to the emergency room, allowing for a more seamless transition to the behavioral health unit, said Dr. Octavio Diaz, chief medical officer for Tenet's Northeast region.
Meanwhile, MetroWest Medical is planning to add 14 adult and 12 pediatric beds to its psychiatric unit at its Leonard Morse campus in Natick in October.
Tenet is also creating a mental health treatment area separate from the emergency room where mental health patients can receive acute-care treatment before they're admitted. This falls in line with a recent push to separate mental health care from what's delivered in the emergency room to improve safety and treatment quality.
Diaz hopes these recent investments will bring the Tenet-owned hospitals closer to meeting the needs of all patients.
“We operate at almost full all the time, at both St. Vincent and MetroWest Medical Center. So there is a significant need for those beds,” Diaz said.
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