In 2016, the Nebraska Department of Health and Human Services, along with its Division of Behavioral Health, recognized the need to study the costs associated with mental health and substance use disorder services. This move was part of their long-term strategic plan to improve behavioral health services across the state.
The resulting cost analysis revealed a significant gap between state reimbursement rates and the actual costs of providing care. Many providers were reimbursed 7% to 35% less than the cost of their services. This underfunding posed a challenge for providers, limiting their ability to expand and maintain essential services.
To address this issue, the Nebraska Legislature, led by Appropriations Committee Chairman John Stinner and Vice Chair Kate Bolz, worked to secure funding to increase reimbursement rates. This funding boost allowed providers to expand services and improve access to care, while also helping to address workforce shortages.
However, access to mental health care remains a concern, as many individuals still cannot afford the services they need. Medicaid is a key payer for these services, and many community providers depend on Medicaid rates to sustain their operations. Providers are paid through a managed care system, where the state contracts with insurance companies that negotiate reimbursement rates with providers.
The Nebraska Legislature determines Medicaid funding, including provider rates, which are posted each July after the start of the new fiscal year. These rates serve as the basis for negotiations between managed care companies and providers. But uncertainty around reimbursement rates has left many providers worried about maintaining services and meeting the needs of their clients.
One solution to this problem is Legislative Bill 380, introduced by State Senator John Fredrickson of Omaha. The bill proposes that the rates posted by the Legislature serve as the minimum amount providers can expect to receive. This would provide businesses with more certainty, helping them maintain and grow their workforce and expand services to meet the community’s needs.
Addressing this issue is crucial to ensuring that the progress made by Nebraska’s mental health and substance use disorder providers is not undone. The state continues to face troubling statistics surrounding mental health and substance use disorders. In Nebraska, suicide is the second-leading cause of death for young people aged 10 to 34, with the state seeing four times as many deaths from suicide as from car accidents.
One in six children aged 6 to 17 and one in three young adults aged 18 to 25 struggle with mental illness. Despite the prevalence of these treatable conditions, many individuals do not receive the care they need.
As the state moves forward, it is essential to continue strengthening the mental health care system to improve access and reverse the troubling trends in mental health outcomes. By prioritizing mental health services and supporting providers, Nebraska can work towards a more resilient system of care.
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