Health Care Policy Mythbusters: Why EHRs, Integrated Care, Demand Side Incentives and Alternative Payment Models Are Killing Folks with Psych Diagnoses and Harming All of Us

Susan Fendell, J.D.

Presenters in this workshop entitled Health Care Policy Mythbusters will explain why advocates for people with psychiatric diagnoses need to have a solid understanding of the effects of current health care policy trends. Americans with depression, bipolar disorder or other serious mental illnesses die 15 to 30 years younger than those without mental illness – a disparity larger than for race, ethnicity, geography or socioeconomic status. Contrary to popular mythology, the primary reason for this disparity is not lack of access to health care providers or lifestyle choices. In fact, people with mental health challenges see health care providers more often than those without.

Rather, the problem is implicit bias and a phenomenon known as diagnostic overshadowing – attributing physical symptoms to psychiatric diagnoses. This workshop will investigate how electronic health records and integrated medical/mental health care contribute to this problem. We will also look at popular conceptions that “demand side incentives,” which shift costs to consumers and alternative payment models, are necessary for and effective in controlling costs, as well as whether health outcome measurements are capable of controlling financial enticements to inappropriately limit needed care. Finally, we will suggest some tactics lawywers can use to alter the current path of health care reform.