Worcester Business Journal

26 2016 Economic Forecast www.wbjournal.com Worcester Business Journal Behavioral health seems to be getting a little more respect from public and private insur- ance payers, thanks in part to legislative changes resulting in better reimbursement for mental health and addiction treatment. With a number of local projects underway to serve those populations, conditions for those in need of treatment will improve. H e a l t h C a re Behavioral health, risk-based contracting to dominate 2016 health care BY EMILY MICUCCI Worcester Business Journal Staff Writer T O P H E A LT H C A R E S T O R I ES O F 2 0 1 5 I n the healthcare field, there's never a dull moment. Federal and state healthcare reform and ever-present pushback from union groups on topics like staffing and price transparency are sure to keep administrators and clinicians on their toes for the foreseeable future. Shifts in the industry are plentiful, but here are three that are likely to be front-and-center in 2016. Michael Krupa, CEO of Health Partners New England, is overseeing construction of a new inpatient psychiatric facility in Devens. More attention for behavioral health Risk-based contracting Continued push for transparency Unions have advocated for commercial insur- ance contracts to be made public in a system where a few providers are paid a lot more money than the rest for the same services. Meanwhile, the Health Policy Commission has said price transparency is a major priority for the year ahead. What the solution will be remains to be seen but don't expect the issue to fade away. n The transition from fee-for-service contracts between providers and insurers has been under- way for a few years. These contracts incentivize providers to manage patients on or under bud- get, while meeting certain quality guidelines. About a quarter of UMass Memorial Health Care's insurance contracts are now risk-based and their share is expected to increase. O n a seven-acre plot of land in Devens, a Winchester-based behavioral health consulting company is in midst of building a 104- bed inpatient facility for people with mental and behavioral health disorders. Attracted by Devens' streamlined per- mitting process and a friendly set of neighbors who don't mind seeing such a facility built nearby, Health Partners New England CEO Michael Krupa said the new Devens location will be an apt extension of the for-profit company's services. For people living in Central Massachusetts who need inpatient treat- ment and have to sometimes wait for days before a bed opens up, often far from home, it could offer a sorely need- ed 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. Massachusetts has what Krupa described as a "pro-behavioral health" governor, plus insurance coverage poli- cies that have been improved in recent years for behavioral health services. A movement toward parity for insur- ance coverage of behavioral health ser- vices, bringing them in line with medi- cal-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 elevat- ed the importance of behavioral health services. "We're really seeing more positive embracing of behavioral health servic- es," Krupa said. S teward Health Care, the state's sec- ond-largest health care system, made headlines when Chief Strategy Officer David Morales called for a new approach to managing the state's Medicaid patients under the state insurance provider MassHealth. Morales, according to State House News Service, said the use of account- able care organizations by MassHealth could save the agency $200 million to $400 million annually while reducing fraud. In an interview with Central Mass Drug crisis, push for parity boosting behavioral health? UMass Memorial CEO calls for more focused ACO approach P H O T O / E D D C O T E

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