Extra Point: Unlike my kids whose idea of a crisis is their iphone app froze or the dog licked the waffle, meaning they have to make another one, there are real crisis situations going on and they are sparking a flurry of new healthcare psych-focused models. The latest is a new mental health facility focused on helping Medicaid patients in Tennessee, and it’s already at capacity. The center focuses on both crisis intervention and other psych needs, but its model has led to some questions from those we interviewed about its designation, whether it turns away crisis patients, and more broadly about its role in mental health crisis intervention. That it doesn’t accept commercial insurance but won’t turn any patients away either has created some hurdles, particularly because most of the patients that police have brought here in the first month have, guess what, been people who have Aetna or BCBS of Tennessee through their employer coverage. We polled payers and physicians about the model and included that in our story. In the end, the findings and early returns suggest there’s growing demand for psych support throughout the health and educational system, particularly at the point of crisis. But as investors enter this space – focusing on outpatient psych, autism, telehealth, and addiction treatment - it will be interesting to see how state policy, payer networks, reimbursement and facility services adjust. Seems unlikely that these quasi psych ERs will fall into a similar quandary as freestanding ERs did in Texas by operating out of network, in part because of the uniqueness of the patient situations and their community partnership approach. Lou Hochheiser, medical director of clinical policy at Humana for many years, once told me he didn’t like the freestanding ERs because they split true emergencies, but this model would seem to be different, if not well-intentioned. Still, when new models emerge that are on the line between ERs, urgent care and social services, there are going to be questions about the best way to promote and pay for their services. Here’s the story: https://thebehavioralhealthhour.com/2019/02/21/mental-health-emergency-room/
