scholarly journals Reimbursement of Apps for Mental Health: Findings From Interviews

10.2196/14724 ◽  
2019 ◽  
Vol 6 (8) ◽  
pp. e14724 ◽  
Author(s):  
Adam C Powell ◽  
Matthias B Bowman ◽  
Henry T Harbin
Keyword(s):  
Mental Health ◽  
Care Delivery ◽  
Coding System ◽  
Reimbursement Mechanisms ◽  
Common Procedure ◽  
The Us ◽  
Varied Range ◽  
Potential Channels ◽  
Physician Work ◽  
Shed Light

Background Although apps and other digital and mobile health tools are helping improve the mental health of Americans, they are currently being reimbursed through a varied range of means, and most are not being reimbursed by payers at all. Objective The aim of this study was to shed light on the state of app reimbursement. We documented ways in which apps can be reimbursed and surveyed stakeholders to understand current reimbursement practices. Methods Individuals from over a dozen stakeholder organizations in the domains of digital behavioral and mental health, care delivery, and managed care were interviewed. A review of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCSPCS) codes was conducted to determine potential means for reimbursement. Results Interviews and the review of codes revealed that potential channels for app reimbursement include direct payments by employers, providers, patients, and insurers. Insurers are additionally paying for apps using channels originally designed for devices, drugs, and laboratory tests, as well as via value-based payments and CPT and HCSPCS codes. In many cases, it is only possible to meet the requirements of a CPT or HCSPCS code if an app is used in conjunction with human time and services. Conclusions Currently, many apps face significant barriers to reimbursement. CPT codes are not a viable means of providing compensation for the use of all apps, particularly those involving little physician work. In some cases, apps have sought clearance from the US Food and Drug Administration for prescription use as digital therapeutics, a reimbursement mechanism with as yet unproven sustainability. There is a need for simpler, more robust reimbursement mechanisms to cover stand-alone app-based treatments.

scholarly journals Reimbursement of Apps for Mental Health: Findings From Interviews (Preprint)

2019 ◽  
Author(s):  
Adam C Powell ◽  
Matthias B Bowman ◽  
Henry T Harbin
Keyword(s):  
Mental Health ◽  
Care Delivery ◽  
Coding System ◽  
Reimbursement Mechanisms ◽  
Common Procedure ◽  
The Us ◽  
Varied Range ◽  
Potential Channels ◽  
Physician Work ◽  
Shed Light

BACKGROUND Although apps and other digital and mobile health tools are helping improve the mental health of Americans, they are currently being reimbursed through a varied range of means, and most are not being reimbursed by payers at all. OBJECTIVE The aim of this study was to shed light on the state of app reimbursement. We documented ways in which apps can be reimbursed and surveyed stakeholders to understand current reimbursement practices. METHODS Individuals from over a dozen stakeholder organizations in the domains of digital behavioral and mental health, care delivery, and managed care were interviewed. A review of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCSPCS) codes was conducted to determine potential means for reimbursement. RESULTS Interviews and the review of codes revealed that potential channels for app reimbursement include direct payments by employers, providers, patients, and insurers. Insurers are additionally paying for apps using channels originally designed for devices, drugs, and laboratory tests, as well as via value-based payments and CPT and HCSPCS codes. In many cases, it is only possible to meet the requirements of a CPT or HCSPCS code if an app is used in conjunction with human time and services. CONCLUSIONS Currently, many apps face significant barriers to reimbursement. CPT codes are not a viable means of providing compensation for the use of all apps, particularly those involving little physician work. In some cases, apps have sought clearance from the US Food and Drug Administration for prescription use as digital therapeutics, a reimbursement mechanism with as yet unproven sustainability. There is a need for simpler, more robust reimbursement mechanisms to cover stand-alone app-based treatments.

Context of Health Policies and the Impact on Implementation of Health Care and Health Interventions

2019 ◽  
pp. 86-103 ◽  
Author(s):  
David A. Chambers
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Delivery ◽  
Health Care Policy ◽  
Care Delivery ◽  
Cancer Control ◽  
Health Interventions ◽  
The Us ◽  
The Impact ◽  
Regulatory Actions

This chapter will discuss the interface between context, health and health care policy, and health care delivery, using examples primarily from the experience of cancer control and mental health care within the US health care system, although drawing on the more general trends in the influence of policy on health care. Primarily, the chapter will describe policy as existing as two distinct spheres of activity. First, it will describe the set of legislative and regulatory actions that governments and organizations use to influence the provision and receipt of health care, which form the context upon which health care is delivered. Second, it will describe policy as a set of interventions that may support or impede the implementation of health and health care innovations. Finally, the chapter discusses how research can be advanced in this space.

Study of Structural Change in Paddy Agriculture under Reorganization of Direct Payment Policy

Impact ◽  
2020 ◽  
Vol 2020 (6) ◽  
pp. 55-57
Author(s):  
Kunio Nishikawa
Keyword(s):  
Structural Change ◽  
Rice Production ◽  
Direct Payment ◽  
Japan Society ◽  
Payment Policy ◽  
The Us ◽  
Shed Light

Rice has long been an integral part of Japan's culture and economy, as well as an important commodity in Japan-US relations, but farmers in Japan are concerned that trouble is afoot due to competition from countries such as the US, where rice production is more competitive, as well as reorganization of direct payment policy. The question is, how can rice production in Japan remain competitive amidst such competition? One researcher is seeking to shed light on the situation and explore how paddy agriculture in Japan can potentially flourish. Dr Kunio Nishikawa is based at Ibaraki University, Japan, whose Japan Society for the Promotion of Science (JSPS)-funded work is exploring the discrepancy in crop output in the US versus Japan, and seeking to find new ways to boost Japan's agriculture.

The mental health burden in acne vulgaris and rosacea: an analysis of the US National Inpatient Sample

2019 ◽  
Vol 44 (7) ◽  
pp. 766-772 ◽  
Author(s):  
V. Singam ◽  
S. Rastogi ◽  
K. R. Patel ◽  
H. H. Lee ◽  
J. I. Silverberg
Keyword(s):  
Mental Health ◽  
Acne Vulgaris ◽  
National Inpatient Sample ◽  
Health Burden ◽  
The Us

scholarly journals Entropic measures of complexity in a new medical coding system

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jerome Niyirora
Keyword(s):  
Longitudinal Data ◽  
Coding System ◽  
Medical Coding ◽  
Coding Systems ◽  
The Us ◽  
Icd 10 ◽  
New Codes

Abstract Background Transitioning from an old medical coding system to a new one can be challenging, especially when the two coding systems are significantly different. The US experienced such a transition in 2015. Objective This research aims to introduce entropic measures to help users prepare for the migration to a new medical coding system by identifying and focusing preparation initiatives on clinical concepts with more likelihood of adoption challenges. Methods Two entropic measures of coding complexity are introduced. The first measure is a function of the variation in the alphabets of new codes. The second measure is based on the possible number of valid representations of an old code. Results A demonstration of how to implement the proposed techniques is carried out using the 2015 mappings between ICD-9-CM and ICD-10-CM/PCS. The significance of the resulting entropic measures is discussed in the context of clinical concepts that were likely to pose challenges regarding documentation, coding errors, and longitudinal data comparisons. Conclusion The proposed entropic techniques are suitable to assess the complexity between any two medical coding systems where mappings or crosswalks exist. The more the entropy, the more likelihood of adoption challenges. Users can utilize the suggested techniques as a guide to prioritize training efforts to improve documentation and increase the chances of accurate coding, code validity, and longitudinal data comparisons.

Re-municipalization of local public services: incidence, causes and prospects

2021 ◽  
pp. 002085232110064
Author(s):  
Daniel Albalate ◽  
Germà Bel ◽  
Raymond Gradus ◽  
Eoin Reeves
Keyword(s):  
Public Management ◽  
Public Services ◽  
Turn Of The Century ◽  
The Public ◽  
Local Public Services ◽  
High Profile ◽  
Global Trend ◽  
The Us ◽  
House Production ◽  
Shed Light

Since the turn of the century, a global trend of re-municipalization has emerged, with cities reversing earlier privatizations and returning infrastructure and public service delivery to the public sector. The reversal of privatization measures is not an entirely new phenomenon. In the US, for example, returning public services to in-house production has been a long-standing feature of ‘pragmatic public management’. However, many cases of re-municipalization that have occurred since the early 2000s represent a distinctive shift from earlier privatization policies. High-profile cases in cities including Paris and Hamburg have thrust re-municipalization into the limelight as they have followed public campaigns motivated by dissatisfaction with the results of privatization and a desire to restore public control of vital services, such as water and energy. Just as the reform of public services towards privatization spawned a vast body of scholarship, the current re-municipalization phenomenon is increasingly attracting the attention of scholars from a number of disciplinary perspectives. The articles contained in this symposium contribute to this emerging literature. They address some of the burning issues relating to re-municipalization, but they also point to issues yet to be resolved and shed light on a research agenda that is still taking shape.

Transgender and Gender Diverse Community Connection, Help-Seeking, and Mental Health Among Black Transgender Women Who Have Survived Violence: A Mixed-Methods Analysis

2021 ◽  
pp. 107780122110138
Author(s):  
Athena D. F. Sherman ◽  
Sarah Allgood ◽  
Kamila A. Alexander ◽  
Meredith Klepper ◽  
Monique S. Balthazar ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Help Seeking ◽  
Longitudinal Research ◽  
Care Delivery ◽  
Poor Mental Health ◽  
Transgender Women ◽  
Gender Diverse ◽  
Diverse Community ◽  
And Gender

Black transgender women are disproportionately affected by violence and poor care-delivery, contributing to poor mental health. Little is known regarding the effect of transgender and gender diverse (TGD) community connection (TCC) on health. This analysis (a) explores relationships between TCC, polyvictimization, and mental health and (b) analyzes how TCC influenced help-seeking following violent experiences among Black transgender women. Mixed-methods data from 19 Black transgender women were analyzed using correlational and thematic content analyses. Findings suggest that TCC is associated with improved help-seeking and mental health among Black transgender women, highlighting a need for longitudinal research to identify approaches for leveraging TCC.

The effect of Medicare Part D on prescription drug composition and demand

2015 ◽  
Vol 42 (2) ◽  
pp. 170-185 ◽  
Author(s):  
David Zimmer
Keyword(s):  
Prescription Drug ◽  
Medicare Part D ◽  
Medicare Part ◽  
Part D ◽  
Content Type ◽  
The Us ◽  
Upper Respiratory ◽  
Nationally Representative ◽  
The Impact ◽  
Shed Light

Purpose – The US Medicare Modernization Act of 2003 introduced optional prescription drug coverage, beginning in 2006, widely known as Medicare Part D. This paper uses up-to-date nationally representative survey data to investigate the impact of Part D not only on drug spending and consumption, but also on the composition of drug consumption. The paper aims to discuss these issues. Design/methodology/approach – Specifically, the paper investigates whether Part D impacted the number of therapeutic classes for which drugs were prescribed, and also whether Part D lead to increased usage of drugs for specific medical conditions that typically receive drug-intensive therapies. Findings – In addition to confirming findings from previous studies, this paper shows that Part D increased the number of therapeutic classes to which seniors receive drugs by approximately four classes. Part D also lead to increased usage of drugs used to treat upper respiratory disease, hypertension, and diabetes. Originality/value – While mostly concurring with previous studies on the spending impacts of Part D, this paper is the first to shed light on other impacts of Part D, specifically with respect to its impact on therapeutic classes for which drugs are prescribed.

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