U.S. lawmakers hope to spur additional electronic health record (EHR) adoption in behavioral health by creating a financial incentive to do so.
The Behavioral Health Information Technologies (BHIT) Now Act, formally known as House Resolution 7427, would appropriate $250 million to be issued over three fiscal federal years by the Center for Medicare & Medicaid Innovation (CMMI) to help finance EHR rollouts.
The legislation also would require divisions within the U.S. Department of Health and Human Services (HHS) — the Office of the National Coordinator for Health Information Technology (ONC) and the Substance Abuse and Mental Health Services Administration — to “develop voluntary standards” for health information technology issues such as privacy, data sharing and minimum clinical standards.
Behavioral health providers must demonstrate that they have acquired an EHR that meets the standards of the ONC set in 2015, and that they are compliant with the Interoperability and Patient Access Rule.
Rep. Doris Matsui (D-Calif.) introduced the BHIT Now Act on April 6 as its primary sponsor. Reps. Markwayne Mullin (R-Okla.), Sharice Davids (D-Kan.) and Ron Estes (R-Kan.) are original co-sponsors of the bill.
The House Committee on Energy and Commerce has received the BHIT Now Act.
Matsui said in a news release the bill is intended to improve the coordination of mental health and physical health care while helping the behavioral health industry grow through the adoption of technology.
“Electronic health records are no longer novel technology – they have become a must-have for patients and providers in our modern health care ecosystem,” Matsui said in the release. “This legislation will open up the door for more behavioral health providers to get their hands on the hardware, software and training they need to leverage vital technology that supports coordinated, high-value care.”
Matsui has made attempts to bring incentive payments to bear on behavioral health EHR adoption in the past. In 2017, she co-sponsored H.R. 3331 to require CMMI to test incentive models for more technology adoption in the behavioral health industry. This bill failed after passing out of the House.
It was later included in the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018 (SUPPORT Act) which became law in October 2018. However, CMMI has yet to develop a pilot to implement the demonstration.
The release also notes that the behavioral health industry has lagged far behind the rest of the health care sector in EHR adoption. However, the behavioral health industry has not had help in a move toward greater EHR adoption in the same way that hospitals and physical health care systems have.
The Medicaid and CHIP Payment and Access Commission (MACPAC), a non-partisan legislative branch research agency, finds that 96% of medical-surgical hospitals and 89% of rehabilitation hospitals use an EHR. But only 49% of psychiatric hospitals use an EHR, according to previous Behavioral Health Business reporting.
Similarly, MACPAC finds that office-based physicians in cardiology, neurology, urology, general practice and internal medicine use EHRs at rates of 89% or higher. Utilization stands at 61% for psychiatry offices.
In 2009, Congress passed the Health Information Technology for Economic and Clinical Health Act (HITECH) as part of the American Recovery and Reinvestment Act. This created incentives related to health care information technology, including incentives for the use of EHRs among physical health care providers. It excluded behavioral health providers.
HITECH allocated $35 billion in Medicaid and Medicare incentive programs to encourage hospitals and providers to adopt EHRs.
It took two years for the incentive program to get off the ground, but after it did in 2011, EHR adoption increased by 53% among non-federal acute care hospitals in the country.
The bill is supported by the American Psychological Association, the Association for Behavioral Health and Wellness, the National Alliance on Mental Illness and the National Council for Mental Wellbeing — among several other groups.
“In order to effectively treat a patient, the doctor must see the whole picture,” Mullin said in the release, adding that behavioral health providers face a steep financial barrier to EHR adoption. “I’m proud to introduce this legislation that will increase access to IT for behavioral health care providers and improve the quality of care patients receive.”
