The American Hospital Association’s (AHA) nearly 5,000 member hospitals, health systems and other health organizations – includes 1,660 member executives from general hospitals and freestanding specialty hospitals that provide behavioral health services. AHA supports the integration of behavioral and physical health and believes hospitals can play a pivotal role in establishing effective partnerships to ensure access to a full continuum of behavioral health care within a community.
As the Trump administration and the 115th U.S. Congress take shape, AHA will continue to advocate on behalf of all health care providers, including behavioral health providers, for high-quality, affordable and accessible health care for all Americans. Key behavioral health advocacy and policy initiatives AHA worked on in 2016 are highlighted below.
- Reforming the Mental Health System. The AHA-supported 21st Century Cures Act, signed into law on December 13, 2016, includes reforms to the mental health system, including provisions related to mental health parity, integration with physical health services, workforce development, and privacy provisions, among others. It also includes adjustments to the Hospital Readmissions Reduction Program to account for socioeconomic status.
- Supporting Medical Innovation. The 21st Century Cures Act is primarily designed to advance the development of medical treatments and cures through investments in research and updates to how new therapies are developed and approved. The major components of the legislation fund new initiatives at the National Institutes of Health (NIH) and the FDA. Specifically, it authorizes $4.8 billion for the NIH to fund new initiatives around precision medicine, cancer, neuroscience, and regenerative medicine.
- Combating the Opioid Epidemic. The 21st Century Cures Act provides $1 billion in grants to states to help address the opioid epidemic. AHA also worked with the Centers for Disease Control and Prevention to develop and distribute a new patient education resource on prescription opioids that outlines evidence-based information about the risks and side effects of the powerful painkillers. Resources are available at www.aha.org/opioidepidemic.
- Fighting Escalating Drug Prices. As a member of the steering committee of the Campaign for Sustainable RX Pricing, AHA has raised awareness with legislators, policymakers and the media of how rising prescription drug prices are putting a strain on the entire health care system. These efforts have included briefings on Capitol Hill and for the media.
- Shaping MACRA Implementation. The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 created a new physician payment and performance measurement system, and AHA is working with CMS to shape implementation by ensuring the regulations make sense, are aligned with other Medicare programs and do not overburden providers. Opportunities remain to further align hospital and clinician performance measurement, and we will work to make that happen. Resources can be found at www.aha.org/macra.
- Improving ‘Two-midnight’ Policy. AHA helped persuade CMS to finalize several positive changes to its burdensome two-midnight policy. In addition, AHA successfully challenged through the courts CMS’s interpretation of its 0.2% payment reduction for inpatient services, convincing the agency to restore the resources that hospitals are lawfully due, restoring $3.1 billion in unjustified cuts.
- Expanding Access to Medicaid. AHA continues to support state hospital associations in non-expansion states to make the case for Medicaid expansion. Montana and Louisiana expanded their Medicaid programs in 2016.
- Collaborating with National Behavioral Health Organizations. AHA works closely with the National Alliance on Mental Illness, the American Psychiatric Association, the National Association of Psychiatric Health Systems, and the Substance Abuse and Mental Health Services Administration.
AHA fosters dialogue among behavioral health leaders and offers many opportunities to take an active role in shaping AHA policies and setting direction for the association and the field. They may have a formal role in association governance and/or policy formation by serving on AHA’s Board of Trustees, Committee on Health Care Strategy and Innovation, Regional Policy Boards, or Councils and Committees. In addition, behavioral health leaders can participate on:
- AHA Psychiatric and Substance Abuse Services Council that leads the Section for Psychiatric and Substance Abuse Services by providing forums linking members with shared interests and missions to advise AHA on policy and advocacy activities and to discuss issues of great importance to behavioral health providers and the field as a whole.
- Advocacy Alliances, including the Advocacy Alliance for Coordinated Care and the Advocacy Alliance for the 340B Drug Pricing Program.
- Conference Calls for small groups of executives to discuss best practices to improve behavioral health care quality and outcomes. In addition, AHA’s behavioral health CEOs are individually contacted to share their views several times a year.
Based on member input, AHA, often in partnership with others, develops and offers resources to support behavioral health providers. Examples include:
- Triple Aim Strategies to Improve Behavioral Health Care. This February 2016 Hospitals in Pursuit of Excellence (HPOE) guide describes strategies, action steps and examples for hospitals, health systems and community stakeholders working to develop a well-coordinated, accessible, affordable and accountable system for delivering behavioral health care.
- Trends in Hospital Inpatient Drug Costs: Issues and Challenges. This October 2016 study was commissioned by the AHA and the Federation of American Hospitals to better understand how drug prices are changing in the inpatient hospital setting and to inform policymakers and stakeholders.
- Task Force on Ensuring Access in Vulnerable Communities. This November 2016 AHA taskforce report outlines nine emerging strategies that can help preserve access to health care services in vulnerable communities.
For information about the overall value of membership at AHA, please see http://www.aha.org/about/membership/value.shtml. More information on AHA’s behavioral health initiatives can be found at www.aha.org/behavioralhealth.