Magazine article Behavioral Healthcare Executive

Providers React to Recession Ripples by Diversifying Levels of Care

Magazine article Behavioral Healthcare Executive

Providers React to Recession Ripples by Diversifying Levels of Care

Article excerpt

The great recession is still sending ripples through psychiatric health centers. With tighter state budgets, providers have experienced a reduction in utilization of residential care and an increase in inpatient and outpatient hospital care. Mark Covall, president and CEO of the National Association of Psychiatric Health Systems (NAPHS), says it's a trend he's been watching unfold for three years or more.

"With a decline in state budgets, it puts more pressure on the residential level of care," Covall says. "But tied into that is the continued move at the state level to move children and adolescents into less restrictive environments, especially as managed care has become more dominant in the Medicaid sector. They're developing more wrap-around, in-home programs and other community-based, non24-hour programs that are having the effect of providing services for these kids outside the residential setting."

For inpatient hospital care, four key measures were on the increase in 2012, according to new NAPHS survey data released in late June:

* Average total days;

* Average total inpatient admissions;

* Inpatient mean length of stay; and

* Occupancy.

Meanwhile, residential treatment trends for freestanding centers and hospital-based programs show decreases for 2012, according to the survey:

* Average days of residential care;

* Average residential admissions;

* Average occupancy; and

* Average length of stay, which dropped 8.7%, from 175 days to in 2011 to 160 days in 2012.

Range of services

Covall says health systems and treatment centers are providing varied levels of care to keep up with the changing market landscape. For example, NAPHS members said in the survey that in psychiatric services for 2012, the level of care most represented was inpatient hospital treatment with 78.8% of members offering psychiatric care. However, for addiction treatment, residential care still remains the most represented. Here, the residential level of care was reported by 47.5% of respondents, followed by outpatient addiction treatment at 36.9%.

"Our members are providing all the different levels of care, including residential, and that trend seems to have intensified over the last few years," Covall says. "Depending on how it's done, other levels of care could be less expensive than residential, so I think budget and financing has a lot to do with it. …

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