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    High Performance

2022 Budget Gaps

September 2, 2021

Given future federal budget reductions in 2022, cash strapped States will have to self-fund more social programming.

Faced with future budget reductions many mental health and addiction treatment programs will find their services impacted by future funding cuts.

While pressures will be felt throughout the service system budget cuts won’t be limited to State funding dollars.

Additional fiscal pressures will come from:

  • Lowered State Medicaid reimbursement rates,
  • reduced affordability of consumer health insurance,
  • the reemergence of managed care programs,
  • an ongoing inability of providers to document quality performance outcomes
  • lack of expertise in applying productivity efficiencies.

These combined engines of change address the fact that current behavioral healthcare is much too expensive. Many programs deliver patient outcomes that range in quality from excellent to marginal. Systemic problems associated with delivery system costs and productivity have made them unsustainable primarily due to affordability.

One area that continues to receive marginal attention by today’s managers is individual program productivity and effectiveness. Productivity defined as: the measure of output (healthcare quality) per unit of input (healthcare dollar) will require immediate upgrades to present work systems if behavioral health programs hope to compete on productivity and performance.

Although addiction treatment and mental health healthcare, has seen growth in labor costs, productivity increases over the same time period has not improved. Most behavioral health programs appear frozen in time operationally. Managing the productivity of skilled labor services and producing quality care appears too much to grasp.

Variations in patient quality outcomes and a lack of credible  performance data is ample evidence of underperforming treatment programs. While the public is continuously demanding greater performance and lower costs of hospital based healthcare systems, behavioral health has been left to on its’ own operate as a separate system.

While policy experts work tirelessly at the state and national levels to make performance changes in healthcare delivery, behavioral health centers are disconnected and on their own, surviving as best they can in a new healthcare economy.