www.macpac.gov
Medicaid and CHIP Payment and Access Commission
September 24, 2021
Behavioral health IT adoption
and care integration
Jessica Kahn, Bebet Herminio Navia, Jr., Brooke
Hammond
CONFIDENTIAL AND PROPRIETARY
Any use of this material without specific permission of McKinsey & Company
is strictly prohibited
September 2021 MACPAC Public Meeting
Friday, September 24, 2021
Presented by Jessica Kahn
Health information
technology and
behavioral health
McKinsey & Company
3
Incentives have helped increase
adoption of electronic health records
… yet adoption has been limited in
behavioral health
$35B
allocated for Medicaid and Medicare incentive
programs encouraging hospitals and providers
to adopt EHR systems
1
As part of the HITECH Act in 2009, significant investments
were made to incentivize electronic health record (EHR) adoption
1
From the inception of the incentive programs in 2011 to 2015, EHR
adoption increased 53 percentage points among U.S. non-federal
acute care hospitals
2
1. “Where Is HITECH’s $35 Billion Dollar Investment Going?" Health Affairs Blog, March 4, 2015.
2. Henry, J., Pylypchuk, Y., Searcy T. & Patel V. "Adoption of Electronic Health Record Systems among U.S.
Non-Federal Acute Care Hospitals: 2008-2015.“ ONC Data Brief, no.35. Office of the National Coordinator
for Health Information Technology. May, 2016.
60%
2011 2008 2009 2012 2010 2015 2014 2013
20%
40%
80%
100%
Any Comprehensive Basic
Incentive programs
take effect
Psychiatric hospitals lag behind other specialty hospitals
in possession of Certified Electronic Health Record Technology
3
3. “Percent of Specialty Hospitals that Possess Certified Health IT.” Office of the National Coordinator for
Health Information Technology. August 2019.
4. Yang N, Hing E. Table of Electronic Health Record Adoption and Use among Office-based Physicians in
the U.S., by Specialty: 2015. National Electronic Health Records Survey. 2017.
96%
89%
87%
59%
49%
Children’s General medicine
and surgical
Rehabilitation Psychiatric Acute long
term care
Office-based physicians practicing psychiatry lag behind other
specialty physicians in EHR adoption
4
96% 95% 94% 94% 93% 93%
89%
89%
88%
87%
86%
73%
70%
61%
Urology
Internal medicine
Cardiology
Neurology
Otolaryngology
General surgery
Orthopedic surgery
General practice
OB/GYN
Pediatrics
Other
Ophthalmology
Dermatology
Psychiatry
McKinsey & Company
4
EHR adoption among behavioral
health providers remains low
primarily due to four factors
Source: “Integrating Clinical Care through Greater Use of Electronic Health Records for Behavioral Health”, MACPAC, June 2021
Interoperable behavioral health solutions
may help bridge the gap: a growing number
of companies are offering solutions designed
for interoperability with other provider types
Behavioral health providers are often unable to invest
in the hardware, software, and training necessary
for EHR adoption due to low operating margins
Behavioral health providers are subject to data-sharing
regulations beyond Certified Electronic Health
Record Technology requirements and may face
challenges implementing compliant systems
Behavioral health providers have less incentive to
adopt EHRs as they are typically not included in
health information exchanges, which often serve
as a catalyst for EHR adoption among other providers
Most behavioral health provider types (psychologists,
social workers, marriage and family therapists, etc.)
were ineligible for the federal incentive packages
spurring adoption of EHR systems
1
1. “EHRs in Behavioral Health – A Digital Future?”, Social Work Today, 2013
Examples of companies with interoperable solutions
NOT EXHAUSTIVE
McKinsey & Company
5
Increasing
adoption of
CEHRT among
behavioral
health
providers
could have
wide-reaching
benefits
1
Sources: “Integrating Clinical Care through Greater Use
of Electronic Health Records for Behavioral Health”,
MACPAC, June 2021, “Behavioral Health Integration”,
SAMHSA
EHR adoption may facilitate the development
of attribution models to realize the captured
value of behavioral health care savings
and enable participation in value-based payment
Enable participation
in value-based
payment
As the behavioral health field moves towards
measurement-based care, supportive EHR
systems are essential to improve the quality and
availability of health reporting, and potentially
ease the burden of reporting to state agencies or
Medicaid MCOs
Improve the quality
of health reporting
EHR adoption and information sharing among
providers may promote coordinated care and in
turn improve population health and healthcare
value, a component of which is reduced costs
Increase clinical
integration and
achieve cost savings
www.macpac.gov
Medicaid and CHIP Payment and Access Commission
September 24, 2021
Behavioral health IT adoption
and care integration
Jessica Kahn, Bebet Herminio Navia, Jr., Brooke
Hammond
