A coalition of over 50 health care organizations come together and urge HHS to modernize health information laws to help stem the tide of opioid misuse.

COALITION MEMBER RESOURCES

• Premier health care alliance opioids and patient safety website opens in a new tab

STUDIES

The Journal of American Medical Association: Ten Steps the Federal Government Should Take Now to Reverse the Opioid Addiction Epidemic opens in a new tab

Early identification and treatment of opioid-addicted individuals reduces the risk of overdose, psychosocial deterioration, transition to injection opioid use, and medical complications…..The federal privacy law known as 42 CFR Part 2 (Confidentiality of Substance Use Disorder Patient Records) should be amended so that opioid addiction can be treated like other medical conditions, improving patient safety and continuity of care.

The New England Journal of Medicine: Protection or Harm? Suppressing Substance-Use Data opens in a new tab

What if it were impossible to closely study a disease affecting 1 in 11 Americans over 11 years of age — a disease that’s associated with more than 60,000 deaths in the U.S. each year, that tears families apart, and that costs society hundreds of billions of dollars? What if the affected population included vulnerable and underserved patients and those more likely than most Americans to have costly and deadly communicable diseases, including HIV–AIDS? What if we could not thoroughly evaluate policies designed to reduce costs or improve care for such patients? These questions are not rhetorical. In an unannounced break with long-standing practice, the Centers for Medicare and Medicaid Services (CMS) began in late 2013 to withhold from research data sets any Medicare or Medicaid claim with a substance-use–disorder diagnosis or related procedure code.

The American Journal of Accountable Care: Treating Behavioral Health Disorders in an Accountable Care Organization opens in a new tab

Despite the physical, economic and societal consequences of behavioral health conditions, about one-third of individuals with these disorders receive no treatment, and the vast majority of the rest receive substandard treatment. Legislative changes in the federal regulation that prohibits sharing patient information related to alcohol and drug treatment without additional patient consent (beyond the standard HIPAA form) are needed. Without these data, ACOs are unable to provide the level of analytics required to manage the health of a population and identify patients for targeted outreach.

Milliman: Economic Impact of Integrated Medical-Behavioral Health Care, Implications for Psychiatry opens in a new tab

The additional health care costs incurred by people with behavioral comorbidities are estimated to be $293 billion in 2012 across commercially-insured, Medicaid and Medicare beneficiaries in the U.S. Based on our literature review on the results of effective integration of medical and behavioral health care programs, we calculate that 9-16 percent ($26 – $48 billion) can potentially be saved annually through effective integration of medical and behavioral services. Unfortunately, many individuals with chronic medical conditions and co-occurring MH/SUD disorders are never diagnosed and treated for their behavioral conditions. Since this study used administrative claim data to identify illnesses and costs, these patients were not identified as suffering from these conditions.

Health Affairs: The Impact of Medicare ACOs on Improving Integration And Coordination Of Physical And Behavioral Health Care opens in a new tab
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The ACO model holds the promise of reducing costs and improving the quality of care by realigning payment incentives to focus on health outcomes instead of service volume. One key to managing the total cost of care is improving care coordination for and treatment of people with behavioral health disorders. We examined qualitative data from ninety organizations participating in Medicare ACO demonstration programs from 2012 through 2015 to determine whether and how they focused on behavioral health care. The biggest challenges included a lack of behavioral health care providers, data availability and sustainable financing models. Nonetheless, we found substantial interest in integrating behavioral health care into primary care across a majority of the ACOs.