It’s been a mixed bag of outcomes for mental and behavioral health providers throughout New Jersey since the state began transitioning them to a fee-for-service payment model last year.
Mental health providers and advocates say many organizations that have switched to the new reimbursement model have fared well for the most part, but some outpatient services are losing money, which may translate to less care for people who need treatment.
“Fee-for-service has really changed the business model in which having patients come in for care is critically important,” said Greg Speed, CEO of Cape Counseling. “There are so many things that are just not reimbursable, and we’re hoping to get some help from the state again.”
New Jersey under Gov. Chris Christie moved away from its contract payment model and adopted a fee-for-service model, which reimburses providers based on federal Medicaid rates after they cover the up-front costs for treatment, care and services.
Christie’s administration officials and legislators at the time said the switch would free up money to expand consumer access to services, and while mental health providers seem stable overall, they said areas such as medication monitoring, residential addiction programs and others are falling into a deficit.
Mary Abrams, senior health policy analyst at the New Jersey Association of Mental Health and Addiction Agencies, said agencies have collectively accumulated a deficit of about $7.3 million, based on responses in a statewide April survey.
Speed said the new model fails to reimburse for things such as nursing support, transportation and other operational costs, and struggling programs could mean delays and decreased hours, mental health professionals, access points and locations as providers find ways to fill in the financial gaps.
“Outpatient services are really what enabled the state to downsize hospital, state psychiatric intake and let people live in their communities,” said Debra Wentz, president and CEO of the New Jersey Association of Mental Health and Addiction Agencies.
“This has been a lifeline to wellness, and we don’t want anyone to not have a positive outcome in health, wellbeing and life because they could not get services soon enough,” she said.
Many providers like the Mental Health Association in Atlantic County that offer community support services breathed a sigh of relief this month when they heard Gov. Phil Murphy’s administration and the state Department of Health would delay transition to fee-for-service for those programs.
Providers will continue to get contract payments for those programs through June 2019.
Officials at the Mental Health Association in Atlantic County, who have expressed concern the new model would limit programs and services, said the delay provides more time to create a payment system that works for both the state and providers.
The good news, Speed and Wentz said, is state officials, including Health Commissioner Dr. Shereef Elnahal, seem to be actively working with mental health providers by listening to their concerns, collecting feedback and data and looking for ways to improve the system.
“State leaders have been very supportive and have kept open communication about the transition, and Elnahal seems to be dedicated to creating the oversight panel that was never created under Christie,” Speed said. “Hopefully then we’ll have a stronger voice with that panel.”