Lawmakers have introduced a new bill that, if passed, would extend funding for electronic health records (EHRs) and other technologies to behavioral health providers.
Behavioral health providers have been slower to adopt EHRs and other technologies than physical health providers. A big reason for that is behavioral health providers were left out of the 2009 HITECH Act, which gave health care providers funding to encourage the “meaningful use” of EHRs.
“More than 90% of hospitals utilize EHRs, however, mental health facilities and substance use treatment centers use these critical tools far less frequently,” Congresswoman Doris Matsui (D-Calif.), a co-sponsor of the bill, told Behavioral Health Business in an email. “The reason for this disparity is clear – previous federal efforts to incentivize health IT uptake excluded behavioral health providers.”
The bill is also co-sponsored by Reps. Sharice Davids (D-Kan.) and Ron Estes (R-Kan.) in the House, and Senators Markwayne Mullin (R-Okla.) and Catherine Cortez Masto (D-Nev.) in the Senate.
“I have long fought for the investments to give our behavioral health community the resources they need for connectivity,” Matsui continued. “The Behavioral Health Information Technology Coordination Act will provide that long-overdue funding and encourage widespread EHR adoption.”
The bill, dubbed the Behavioral Health Information Technology (BHIT) Coordination Act, would dedicate $20 million a year in grant funding over five fiscal years (FY 25-29) to mental health, substance use disorder and other behavioral health providers to purchase or upgrade health information technology and support services. If passed, the funding will be distributed through the Office of the National Coordinator for Health Information Technology, and the maximum amount a provider could be awarded is $2 million.
To put that in perspective, the average implementation cost of an EHR system at a five-physician practice is estimated at $162,000, according to a study by Health Affairs.
“The top line is it would improve patient care and job satisfaction for physicians, nurses and therapists,” Dr. Michael Genovese, Acadia’s chief medical officer, told BHB. “Those two things are symbiotic. The more satisfied the clinicians are, the better care the patients will get and then that just sort of snowballs.”
Acadia is the largest pure-play behavioral health care provider in the U.S. It operated 250 facilities with about 11,000 beds in 39 states and Puerto Rico at the end of 2022.
Genovese said that cost has been the main reason behavioral health providers have shied away from implementing EHRs before this bill.
“[EHRs] are really, really expensive. And it’s hard to think of another barrier. Not having one is a barrier to hiring people,” Genovese said. “You get residents and nursing students coming out who are used to being on electronic medical records. And then you said, ‘Well, now you’re getting on paper.’ That’s shocking to them, and it’s difficult for them to make that transition. So I think financial [implications] is the barrier.”
Only about 46% of psychiatric hospitals use EHRs, compared to 95% of general medicine and surgical practices.
Eligible providers, including psychiatrists, clinical psychologists, nurse practitioners specializing in psychiatric services, clinical social workers, as well as psychiatric hospitals, community mental health centers, and residential or outpatient mental health or SUD treatment facilities, would be able to apply for the funding.
Behavioral health insiders have long advocated for funding to implement EHRs and other health IT services.
“EMRs had been around for many years before meaningful-use incentives came in, and there just had not been much uptake,” Andrew Lynch, Acadia Health’s chief strategy officer, previously told BHB. “Once meaningful use came in on the med surg side, you saw this big acceleration. For example, from 2011 to 2015, you saw a 53% increase in non-federal acute care hospital EMR use. This big spike in EMRs was driven by meaningful use.
“We didn’t get that on the behavioral health side; correspondingly, you didn’t see that growth.”
Several behavioral health providers and associations in the industry, including Acadia, Centerstone, the American Psychiatric Association (APA), the American Psychological Association (APA) and the National Alliance on Mental Illness (NAMI), have come out to support the bill.
Genovese stressed that implementing EHRs and other technologies would help improve patient safety and streamline care. Many behavioral health providers still use faxes and write notes on paper, which can lead to mistakes. Going digital could also support breakthrough advancements in the field.
“We’re making such advances in the treatment of psychiatric diseases,” Genovese said. “There’s so much more that we can do to treat things like major depressive disorder and post-traumatic stress and addiction that we’re successful and we can help people lead better lives. And this would exponentially assist our efforts in doing that. It’s the right time.”