Health and Human Services Interim Committee discusses future behavioral health and value-based care reform
The Utah Legislature continued its interim work this week after a summer break with a Health and Human Services Interim Committee meeting on Sept. 15. The topics discussed in the meeting include substance abuse and mental health legislation suggestions and value-based health care reform.
Richard Nance, president of the Association of Utah Substance Abuse Professionals, made policy suggestions for the next legislative session on the behavioral health system and on workforce depletion issues.
First, Nance highlighted the continued waste of sublocade, a medication-assisted treatment (MAT) used for opioid-use disorder (OUD) — including treating heroin. He said the treatment is being wasted due to the treatments being ordered directly for the individual patient.
Therefore, if the patient does not arrive for the treatment — or “gets cold feet” as Nance said — the treatment cannot be used on another patient and must be disposed of. He said Medicaid is mainly paying for this MAT.
“The medication has to be destroyed if it’s not being used because it has a specific patient’s name attached to it… State and federal taxpayer dollars are literally being thrown down the drain.”
Nance also highlighted that as wage rates for workers increase, reimbursement rates stay the same — which is especially hurting small providers. He said providers have to use $4,000-$8,000 signing bonuses to entice prospective employees.
“Provider costs are going up. Reimbursement rates are not. This puts providers in a vice. If they can’t compete for a workforce, they will go out of business one way or another. This will particularly hurt small providers who provide specialized treatment services.”
He also recommended the legislature consider creating a new license class for trained addiction counselors and more funding to higher education programs. He said this would expand the capacity by including more qualified workers.
Next, Rep. Suzanne Harrison spoke to promote value-based care in Utah and outlined focus areas for future legislation to use value-based models. She outlined four areas to save money and improve health in Utah: elimination of wasteful spending, increasing high value care, keeping people covered, and increasing price transparency.
To do these things, Harrison said the legislature needs to focus on investing in primary care. She said Utah is 49th of the 50 states in primary care providers per 100,000 people. An investment in primary care would allow for providers to intervene earlier into a patient’s developing medical condition — when they are cheaper to address. She said this will save the health care system lots of money.
“An ounce of prevention is worth a pound of cure.”
She said the money saved from higher value care will allow more funds to pay more for innovative models of care and investment more into value-based care infrastructure.
Harrison said she will propose a bill to include the National Diabetes Prevention Program into Medicaid coverage. She said this would save billions of dollars in Utah on diabetes care funding. Investing in prevention will keep people out of hospitals and save money, according to Harrison.
“If we can keep people out of hospitals, that is the fiscally responsible approach.”
She also wants to simplify the Medicaid enrollment and application process to ensure more coverage across underserved communities. She wants to remove administrative red tape and use the agency consolidation to “evaluate process and make improvements.”
She also wants to address coverage and benefits and reward providers for improved outcomes.