Bracing for change in the new year

For the rest of the country, there is a litany of puzzling questions. Answers could bring either transformational change in mental healthcare or perhaps something closer to the status quo. At this point we don’t know.

• If tax cuts are extended, will that put a target on healthcare services including mental healthcare at school district and state levels?
• Will insurance coverage parity (or steps toward it) between mental and physical healthcare continue?
• What about the ACA? Will the new administration follow through with threats to weaken it? (Though the individual mandate was repealed under the first Trump administration, the Act largely held up. Same for the Cares Act, which was signed into law by then-President Trump in 2020.)

In five minutes, you and I could come up with 50 more questions about the fate of healthcare in America for the next two to four years. Or beyond. 

The potential for wholesale change at the federal level has spawned mounting uncertainty and growing anxiety inside provider and patient populations nationwide. 

What we do know is this

The new administration will be in a more advantageous position to assert federal power over any number of healthcare policies, agencies, and programs. But that doesn’t mean the flex will be successful. There are limits to presidential powers. But will laws around those checks and balances hold up? Yet another question.  

We also know this: The federal deficit is, in the opinion of many economists, experiencing unsustainable growth, finishing up 2024 at more than $1.8 trillion. An extension of the 2017 tax cuts (many of which will expire at the end of 2025) would likely require offsets to the federal budget. That being the case, healthcare will almost certainly take a hit.  

Safe to say, the mental healthcare sector, already taut, will be pressure tested once again. We need to be prepared. 

The need for awareness 

With the potential for change in mental healthcare in the offing, it’s important to raise your awareness game. Monitor credible press (which is to say, not social media) including trade publications and association (state and federal) bulletins. Groups like the American Psychological Association and the American Medical Association are poised to publish and take important positions that may well influence legislation and your practice. No surprises. We all have a responsibility to be aware of what is coming down the pike.

Fortifying your practice

I get that this might be one of those easier-said-than-done pieces of advice (so many providers are saddled with outdated technology that limits capabilities, for example), but hear me out. I’ve heard from many providers over the last few years who are ready for change but have little bandwidth or tolerance for doing it. If wholesale changes within your practice are off the table, look around and see what smaller tasks you can take care of now that would help improve your position for at least the near future. Bolster your outreach and connections with peers. Affirm your support of professional organizations or interest groups with which you align. Are there systems or functions within your practice that you can be proactive about shoring up?  

A time for flexibility  

This is about a mindset more than anything else. Many providers are locked into doing things—treatments, business practices—a certain way. While that approach might have worked fine in the past, that mentality is risky during a period of change in the world around you. Recognize that change is highly likely and that resisting or ignoring it could be detrimental to the care you provide and the business you run. The healthcare sector is overdue for new ideas that help meet the challenges of care today. Now is the time to consider them, if not embrace the ones that make sense for you and your patients. 

Respond, react 

Whether you view the turnover of the executive and legislative branches of the federal government as a good or bad thing depends largely on which side of the political fence you sit. But for everybody, the potential for great change in mental healthcare is there and preparation is paramount. 

What matters now is being in the best possible position to react to change so that you can still meet your patients’ needs and sustain, if not grow, your practice. And for the sake of your patients and business, be steadfastly bipartisan in how you react. The reality will be what it is. Now, it’s all about what we do about it to keep helping people. 

For one thing, with so much uncertainty, it’s not hard to envisage that anxiety will be at an all-time high within many patient populations. Members of immigrant, minority, female, LGBTQIA2S+, and student communities (among others) are especially on edge following a campaign perceived by some as one of fear, hate, and division. Be ready to react to a possible rush of new business from the stressed patient population.

Silver lining?

For new, credentialed mental health providers, perhaps a period of transformational change in mental healthcare can be viewed as an opportunity. Demand will be there. That’s what any new business needs. 

For supervisors and mentors, it’s time to guide your pre-licensed charges to a state of readiness. Work with a sense of urgency, but don’t skip steps that might compromise care, business integrity, or security.

One more thing we can do

The 2024 election cycle was exhausting. And the outcome for many people only added to the fatigue. 

For everybody, there’s uncertainty. 

While daunting challenges may await, there’s hope in the power of people. By eschewing the divisiveness, we can overcome new roadblocks to patient care and provider support. Galvanized, we are not powerless.  

All hands.  

Samant Virk, MD, is the CEO and founder of MediSprout.