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HEALTH • November 30, 2015 19 Health Partners New England, a behavioral health consulting firm, chose Devens as a future home for its first inpatient psychiatric facility. CEO Michael Krupa said Central Massachusetts is significantly underserved. CEO Michael Krupa said the new Devens location will be an apt extension of the for-profit company's consulting services. For people living in Central Massachusetts who need inpatient treatment and have to sometimes wait for days before a bed opens up, often far from home, it could offer a sorely needed option close to home. "By opening these beds up, it will both be closer (to Worcester and Lowell) and by adding all this capacity, it should hugely reduce these wait times," Krupa said. Krupa hopes the building will be enclosed in time for crews to begin working inside the building this winter and he anticipates an opening in September 2016. And while a for-profit , standalone behavioral health facility is unique in the region, Krupa doesn't expect that Health Partners New England will be the only newcomer offering services in Central Massachusetts. Improved environment for behavioral health? Massachusetts has what Krupa described as a "pro-behavioral health" governor, plus insurance coverage policies that have been improved in recent years for behavioral health services. A movement toward parity for insurance coverage of behavioral health services, bringing them in line with medical- surgical coverage, has also been about three or four years in the works, and the opioid addiction crisis that's rampant in New England further elevated the importance of behavioral health. "We're really seeing more positive embracing of behavioral health services," Krupa said. Whether Health Partners New England will be joined by another for-profit provider in the region remains to be seen, but planning for community hospital-based behavioral health projects in other parts of Worcester County is well underway. Petersham, Webster projects on deck Like Health Partners New England, new facilities planned for Petersham and Webster are designed to treat "dual-diagnosis" patients, who suffer from mental illness as well as addiction. These projects back up Krupa's assertion that the environment is improving somewhat for behavioral health services as a business. Such services are not particularly lucrative for health care providers, which has led to a system that falls short of meeting the needs of people with men- tal health and substance abuse disorders, or both. But there have been some important developments that are driving new investment in behavioral health services in Massachusetts. Among them is the opioid epidemic that state officials have vowed to address in midst of a huge spike in opioid-related deaths. Rebecca Bialecki, vice president of Community Health at Gardner-based Heywood Healthcare, believes the crisis helped boost the fight for parity in the behavioral health arena. "It's sad to see that it took a crisis to get there," Bialecki said. Commercial insurers are becoming more adept at authorizing coverage, according to Bialecki. Meanwhile, provisions under the state health care MENTAL HEALTH ACCESS, BY THE NUMBERS Number of inpatient psychiatric beds per 100,000 people in Central Massachusetts in 2014, the second lowest regional ratio in the state, behind the Cape and Islands Growth rate of inpatient psychiatric beds in Massachusetts from 2010 to 2014 Approximate percentage of the population with serious mental illness Percentage of the population with substance abuse disorders 17.3 2% 5% 10% Source: Department of Public Health Access to inpatient psychiatric beds is limited in Central Massachusetts, according to the Department of Public Health, but there's been a small increase in statewide capacity. Here are some key figures related to mental health services and need in the Bay State. reform law, Chapter 224, require commercial payers to treat those with behavioral health disorders the same way they would treat medical-surgical patients. For this reason, Bialecki is hopeful that a new inpatient facility that Heywood is planning to build in Petersham will at least break even, which is about as much as the system can hope for, she said. Serving as the executive director of the Quabbin Retreat, Bialecki is spearheading the project. It's moving ahead despite news that a $1.3 million grant to help fund the project was cut from the state bud- get. Renovation of the facility, formerly occupied by the Sisters of Assumption, is slated to begin next year. The facility probably won't be a profit center for Heywood, said Bialecki, who said the system is hoping it will run in the black from insurance pay- ments and rent generated by tenants that will lease some of the space for other purposes. "We want to have it be sustainable," Bialecki said. Cost concerns aside, Bialecki said the need for more behavioral health beds in the North Central Massachusetts area is profound. She said it's rare to find people who don't have a mental illness occur- ring in conjunction with addiction, and dual-diag- noses beds are even harder to come by in the state than beds reserved for patients with mental illness only. Meanwhile, the area is plagued by a suicide rate that's "several times the state average," particu- larly among young- to middle-aged men. Economic conditions and geographic isolation are likely driv- ers, Bialecki said. Public payer challenges persist Despite some legislative changes that have improved coverage for mental health patients, pub- lic insurers, like MassHealth, don't reimburse pro- viders nearly enough to break even on services offered. Commercial insurers reimburse at a higher rate, but it's tough for hospital systems serving a Continued on Page 29

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