Advancing the Blueprint to Mental Health Parity Reform.

This Viewpoint discusses the current state of mental health parity reform, proposed amendments, and the challenges and considerations in play.

Rebalancing Controlled Substance Regulations in Telemedicine.

This Viewpoint elucidates major components of the proposed rules about controlled substance prescribing in telehealth, highlights evolving considerations with the US Drug Enforcement Agency's approach, and offers potential improvements before finalization of the rules.

The Emerging Role of Alternative Payment Models in Promoting Mental Healthcare Equity.

Healthcare programs based on alternative payment models (APMs) have gained in prominence for their increasingly well-established impact on quality and cost outcomes. While APMs also appear to have potential utility in addressing healthcare disparities, it remains unclear how they should best be leveraged for this purpose. Because the landscape of mental healthcare presents unique challenges, it is crucial that lessons from past programs are integrated into the design of APMs in mental healthcare so the promise of their impact on the goal of equity might be fulfilled.

Payer-Level Care Coordination and Re-admission to Acute Mental Health Care for Uninsured Individuals.

This study determined the short- and long-term outcomes associated with payer-level care coordination, compared with care-as-usual in "high-utilizers" of acute care services in a large, publicly funded safety net system. Administrative claims data (2016-2020) were analyzed. All patients were "high-utilizers," defined by the State of Florida as either (a) 3 + more acute care episodes in a 6-month period or (b) 1 + acute care episodes in the past 6 months lasting 16 + days. Patients enrolled in care coordination (n = 178) were compared to usual care (n = 1,127) on rates of re-admission and post-discharge engagement in outpatient/residential services. Care coordination was associated with reduced rates of re-admission, significant cost savings, and enhanced engagement in post-discharge non-crisis services. In light of the observed clinical and economic benefits associated with care coordination, payers, policymakers, and administrators of acute care settings should consider potential return on investment for allocation of resources to support specialty care coordination programs.

Mobilization of Telepsychiatry in Response to COVID-19-Moving Toward 21st Century Access to Care.

The COVID-19 pandemic threatens to disrupt the provision of mental health services. In response, policymakers, administrators, and providers have taken bold steps toward enabling telepsychiatry to bridge this sudden gap in care for our most vulnerable populations. With rapid deregulation and adoption of this modality of care, careful consideration of issues related to policy and implementation is essential to maximize its effectiveness and mitigate unintended consequences. Though the crisis places the healthcare system under strain, it sets the stage for a lasting shift in not only how care is delivered, but also our beliefs around the system's capacity for rapid, innovative change.