Congress should add psychologists to the HITECH Act to make them eligible for Medicare electronic health records incentives.

What is the HITECH Act? The Health Information Technology for Economic Clinical Health (HITECH) Act significantly expanded the U.S. government's efforts to establish a national electronic health records (EHR) system. Such a system enables authorized health care professionals and hospitals to access centralized information such as lab test results and medication lists to provide coordinated, safer and efficient patient care. The Act includes significant mental health record confidentiality protection.

The Act authorizes the Centers for Medicare & Medicaid Services to provide a reimbursement incentive (Medicare and Medicaid) for physician and hospital providers who are successful in becoming “meaningful users” of EHR.  Meaningful use eligible professionals—doctors, osteopaths, dentists, dental surgeons, podiatrists, optometrists and chiropractors—receive up to $44,000 in incentives over six years. These incentive payments began in January 2011, and will gradually phase down by 2016 for Medicare and 2025 for Medicaid. Starting in 2015, providers are expected to be actively utilizing EHRs in compliance with the meaningful use definition or be subject to financial penalties under Medicare. 

Unfortunately, the HITECH Act excluded mental and behavioral health providers and treatment facilities from participating in the Medicare and Medicaid EHR incentive programs.

Why include psychologists? Including psychologists and other mental and behavioral health providers will help ensure that Medicare and Medicaid patients receive coordinated, high-quality care. More specifically, the inclusion of psychologists will generate savings for the programs. According to a recent Milliman actuarial study, people with serious mental disorders have medical costs 10 to 15 times higher than patients without psychiatric illnesses. The majority of these expenses reflect hospital emergency admissions resulting from psychiatric or medical emergencies. Recognizing mental health professionals as eligible “meaningful users” under the law will promote integration of psychology and mental health in primary care settings, reduce adverse drug to drug interactions, reduce duplicative tests, and provide necessary information to the emergency department at hospitals to triage patients more effectively.

Health information technology is the bedrock of any effort to coordinate and integrate care for patients across all modalities of care. Achieving healthcare integration (mental health into primary care) is hampered without EHR systems permitting mental health providers to communicate with medical/surgical providers already included in the HITECH Act.

What can Congress do? Congress can correct this exclusion by supporting and passing legislation to enable psychologists and other key behavioral health providers (psychiatric hospitals, community mental health centers, addiction treatment facilities) to qualify for much-needed EHR incentives to enhance quality of care. Congress is aware of the pressing need to advance Behavioral Health Information Technology as demonstrated by the bills that were introduced across the chambers in the 113 th Congress through the leadership of Senators Rob Portman (R-OH), Sheldon Whitehouse (D-RI), and Representatives Tim Murphy (R-PA) and Ron Barber (D-AZ).