1 / 27

NMHU 3 rd Annual Alcohol & Substance Abuse Treatment Conference

This conference will explore four key strategies to address alcohol and substance abuse among the Medicaid expansion and Health Insurance Exchange populations in New Mexico. Learn about the prevalence of behavioral conditions and the potential impact of the Affordable Care Act on access to treatment and care. Gain valuable resources and insights into the changing healthcare environment and opportunities for enrollment and payment.

tbourque
Download Presentation

NMHU 3 rd Annual Alcohol & Substance Abuse Treatment Conference

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. NMHU 3rd Annual Alcohol & Substance Abuse Treatment Conference May 12-15, 2014

  2. The Affordable Care Act: Four Key Strategies

  3. Prevalence of Behavioral Conditions Among Medicaid ExpansionPopulation: New Mexico CI = Confidence Interval Sources: 2008 - 2010 National Survey on Drug Use and Health (Revised March 2012) 2010 American Community Survey 5

  4. New Mexico Medicaid Expansion Projections: • Medicaid Expansion = 170,472 • SMI (4.3%) = 7,330 • SERIOUS PSYCH DISTRESS (11.2%) = 19,093 • SUD (8.4%) = 14,320 • TOTAL = 40,743

  5. Prevalence of Behavioral Conditions Among Health Insurance Exchange Population: New Mexico CI = Confidence Interval Sources: 2008 - 2010 National Survey on Drug Use and Health (Revised March 2012) 2010 American Community Survey 7

  6. New Mexico Marketplace Exchanges Projections: • MARKETPLACE EXCHANGES = 157,091 • SMI (2.8%) = 4,399 • SERIOUS PSYCH DISTRESS (6.1%) = 9,583 • SUD (17.6%) = 27,648 • TOTAL = 41,630

  7. New Mexico Data • Marketplace Plan Selection = 32,062 • Medicaid/CHIP Enrollment = 60,378 • Total = 92,440 • 30 % BH Disorders = 27,732 of 82,373

  8. Enrollment Resources • SAMHSA Enrollment Webpage • http://www.samhsa.gov/enrollment/ • State Reform Exchange Decisions • http://www.statereforum.org/node/10222 • Enroll America Best Practices • http://www.enrollamerica.org/best-practices-institute • Healthcare.gov • http://www.healthcare.gov/marketplace/index.html • HHS Partners Resources • http://www.cms.gov/Outreach-and-Education/Outreach/HIMarketplace/index.html

  9. SAMHSA HEALTH REFORM TOOLKITS • http://tiny.cc/CommunityPrevention • http://tiny.cc/ConsumerPeerFamily • http://tiny.cc/HomelessServices • http://tiny.cc/CriminalJustice • http://tiny.cc/TreatmentProviders • http://tiny.cc/GettingReady (GENERAL)

  10. Changing Health Care Environment • Prevention/Wellnessrather than illness • SA/MH Services are Essential Health Benefit • Quality rather than Quantity – saving costs through better care rather than less care • Inclusive – Goal is to provide access to care • Public Payers’ Roles changing • Implications for the Workforce

  11. Opportunities • ACA – new enrollment and payment opportunities • Emerging science • Healthcare integration • Parity – MHPAEA Final Rule • AG’s call for treatment rather than incarceration for SA • ↑ understanding of BH role in health promotion, prevention, treatment and costs • President’s/nation’s attention to MH issues • www.mentalhealth.gov • www.creatingcommunitysolutions.org

  12. DAILY DISASTER OF UNPREVENTED AND UNTREATED M/SUDs 14

  13. Region 6 Profile 1U.S. Census 2010 resident population, all ages 2U.S. Census 2010 3SAMHSA, NSDUH 2010-2011, Table 19. Dependence on or Abuse of Illicit Drugs or Alcohol in Past Year among Persons Aged 18 or Older (Substance Use Disorder). 4SAMHSA, NSDUH 2010-2011, Table 22. Serious Mental Illness in Past Year among Persons Aged 18 or Older (revised October 2013). 5CDC, National Vital Statistics System-Mortality (NVSS-M) 2010, per 100,000

  14. MENTAL HEALTH & ADDICTION EQUITY ACT (MHAEPA) • The Mental Health Parity and Addiction Equity Act requires insurance groups that offer coverage for mental health or substance use disorders to provide the same level of benefits that they do for general medical treatment. Visit "Parity" to learn more.

  15. Mental Health Parity and Addiction Equity Act (MHPAEA) A group health plan and a health insurance issuer offering health insurance coverage in the group or individual market must ensure that Financial requirements (such as copays and deductibles) and Treatment limitations (such as visit limits) applicable to mental health or substance use disorder (MH/SUD) benefits are no more restrictive than the predominantrequirements or limitations applied to substantially all medical/surgical benefits.

  16. MHPAEA/ACA: Projected Reach *These estimates include individuals and families who are currently enrolled in grandfathered coverage

  17. 2015 BUDGET/WORKFORCE • SAMHSA 2015 PROPOSED BUDGET

  18. PROTECTING THE HEALTH OF CHILDREN AND COMMUNITIES • Now Is the Time – $130 M (+ $15.0 M) • $115 M continued from FY 2014 • Science of Changing Social Norms (+ $4 M) • Peer Professionals (+ $10 M) • Workforce Data (+ $1.0 M)

  19. STRENGTHENING & INTEGRATING CARE • Primary Care and Addiction Services Integration (PCASI) – + $20 M • Allow addiction treatment providers to offer an array of physical health and addiction treatment services • Modeled after Primary/Behavioral Health Care Integration (PBHCI) program

  20. LEADING CHANGE 2011 – 2014 8 STRATEGIC INITIATIVES LEADING CHANGE 2.0: 2015 – 2018 • Out for public comment this month • Will contain 6 initiatives • Will guide the next 4 years • Final early fall

  21. SAMHSA OF THE FUTURE – FY 2014 AND BEYOND • SAMHSA’s Strategic Initiatives 2015 – 2018 • Prevention • Health Care and Health Systems Integration • Trauma and Justice • Recovery Support • Health Information Technology • Workforce SAMHSA’s Strategic Initiatives 2011 – 2014 1. Prevention 2. Trauma and Justice 3. Military Families 4. Recovery Support 5. Health Reform 6. Health Information Technology 7. Data, Outcomes & Quality 8. Public Awareness & Support SAMHSA’s Strategic Initiatives Business Operations Staff Development Resource Investment Health Financing Communications Policy Data

  22. SAMHSA’S THEORY OF CHANGE

  23. “NOT YOUR GRANDMOTHER’S SAMHSA” • Leadership & Voice – Influencing Public Policy • Data & Surveillance • Practice Improvement • Grant Making w/ a Designated Purpose • Regulation/Guidelines • Public Awareness/Education

  24. Thank you! Michael Duffy SAMHSA Regional Administrator-HHS Region VI (AR, LA, NM, OK, TX) US Dept. of Health and Human Services 1301 Young Street Suite 1030 Dallas, Texas 75202 michael.duffy@samhsa.hhs.gov Office: 214-767-0522

More Related