How will the BHA balance the shifting policy landscape around telemedicine?
Telebehavioral health services have become a critical source of care for many since the start of the COVID-19 pandemic. State and federal policymakers have increased access to telemedicine during the ongoing public health emergency, but the BHA will need to plan for the potential repeal of waivers that allowed that increase. Payer reimbursement policies, adaptations for the use of telephone and live chat, and the use of HIPAA-compliant platforms are just some of the issues the BHA will need to address. An executive order issued October 3 calls for an increase in the availability of telehealth services by encouraging – and possibly funding – organizations to promote both in-person and telehealth activities in the long term, which may help boost these efforts.
How will the BHA increase access across all insurance types?
Health First Colorado, (Colorado’s Medicaid plan), covers over 1.3 million people – over 22% of the state’s population. But the Department of Health Care Policy and Financing (HCPF), the state’s Medicaid agency, and the Division of Insurance (DOI), will not be a part of the BHA. Instead, HCPF and the DOI have committed to lead the conversation and align with BHA recommendations. The extent to which Medicaid and private insurance efforts will be integrated into the BHA will also be explored in Phase One.
However, alignment between payers is essential to successfully implementing many of the Blueprint’s recommendations. For example, standardizing guidelines across public and private payers so that more providers are in-network has been identified as an opportunity for improvement – more in-network providers will provide more Coloradans with options when seeking care.
But how will the BHA incentivize providers to join the networks to begin with? Rates of payment and reimbursement from payers are a longstanding issue for many behavioral health providers. Payment for care coordination services is also a concern. The BHA will have its work cut out for it in attempting to implement consistent, fair, reimbursement rates for behavioral health services across payers. Both HCPF and the DOI stated in a virtual town hall meeting on October 7 that they will rely on the BHA to develop the care coordination model and determine what the appropriate rates should be and reiterated their commitment to align with BHA priorities and recommendations, but questions remain about the extent to which this will happen.
Improving behavioral health care in Colorado will not be an easy feat. The questions above are just some of the considerations that have come up, and it is clear that an overhaul of the current behavioral health system in place will take time – and money. In addition to many deep-rooted complexities in the health care system, issues like stigma associated with mental health or substance use are difficult to change no matter what policies are in place.
How will the Blueprint meet the needs of people today and build upon the work many providers across the state have tirelessly advocated for? Many of the Blueprint’s longer-term recommendations will require legislative change and significant transformation to the system. But the creation of a new behavioral health administration and expanding telebehavioral health services are first steps toward ensuring that all Coloradans have improved, immediate access to the care they need, when they need it.
Related Blogs and Research