Posts Tagged ‘Behavioral Health’

Infographic: Medicaid’s Role in Behavioral Healthcare

May 19th, 2017 by Melanie Matthews

Medicaid restructuring as proposed in the American Health Care Act could limit states' ability to care for people with behavioral health conditions, according to a new infographic by the Kaiser Family Foundation.

The infographic details how Medicaid currently enables people with behavioral health needs to access care and how reduced federal spending could limit behavioral health coverage and services.

Behavioral Health Patient Engagement: Using Motivational Interviewing Techniques and Strategies To Improve OutcomesAs the critical role of an engaged, activated healthcare consumer becomes more apparent in a value-based healthcare system, healthcare organizations are focusing on patient engagement and activation programs.

In a recent industry survey on trends in patient engagement, healthcare organizations reported that behavioral health conditions presented a particular challenge to patient engagement initiatives. However, there is robust evidence that motivational interviewing is a powerful approach for treating substance abuse, anxiety and depression.

Behavioral Health Patient Engagement: Using Motivational Interviewing Techniques and Strategies To Improve Outcomes, a 45-minute webinar now available for replay, Mia Croyle with the University of Wisconsin School of Medicine and Public Health shares key learnings from patient engagement initiatives targeted at patients with behavioral health conditions.

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Infographic: How State Budget Cuts Are Impacting Mental Healthcare Services

September 28th, 2016 by Melanie Matthews

State mental healthcare budget cuts have caused an increase in emergency room visits for patients seeking mental health treatment with a total of 5.5 million patients seeking care in these facilities each year, according a new infographic by the Cummings Institute.

The $38.5 billion it costs hospitals to take care of these patients could be significantly reduced by integrating mental health professionals within the ER and hospital settings. The infographic looks at the impact of these budget cuts and looks at possible solutions.

Behavioral health conditions affect nearly one of five Americans, leading to healthcare costs of $57 billion a year, on par with cancer, according to a 2009 AHRQ brief. Despite this impact, and the ACA's provision for behavioral healthcare as an essential health benefit, progress toward total integration of behavioral healthcare into the primary care system has been slow.

2015 Healthcare Benchmarks: Integrating Behavioral Health and Primary Care captures healthcare's efforts to achieve healthcare parity and honor the joint principles of the patient-centered medical home, including a whole person orientation and provision of coordinated and/or integrated care.

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Infographic: Substance Abuse Trends

July 27th, 2016 by Melanie Matthews

Substance abuse—involving drugs, alcohol or both—adversely impacts individuals, families and communities. Stopping substance abuse before it begins can increase a person's chance of living a longer, healthier and more productive life, according to a new infographic by Healthy People 2020.

The infographic examines adolescent alcohol or illicit drug use trends and Healthy People 2020 targets for adolescent substance use and binge drinking in adults.

Behavioral health conditions affect nearly one of five Americans, leading to healthcare costs of $57 billion a year, on par with cancer, according to a 2009 AHRQ brief. Despite this impact, and the ACA's provision for behavioral healthcare as an essential health benefit, progress toward total integration of behavioral healthcare into the primary care system has been slow.

2015 Healthcare Benchmarks: Integrating Behavioral Health and Primary Care captures healthcare's efforts to achieve healthcare parity and honor the joint principles of the patient-centered medical home, including a whole person orientation and provision of coordinated and/or integrated care.

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HINfographic: Trends in Integrating Behavioral Health & Primary Care

August 10th, 2015 by Melanie Matthews

Almost two-thirds of healthcare organizations have integrated behavioral health and primary care to some degree, with 31 percent achieving "close collaboration onsite in a partly integrated system," according to 2015 Healthcare Intelligence Network metrics.

A new infographic by HIN examines the level of integration achieved by healthcare organizations, plans to integrate within the next 12 months and the percent of organizations using telehealth for behavioral health consults.

2015 Healthcare Benchmarks: Integrating Behavioral Health and Primary CareBehavioral health conditions affect nearly one of five Americans, leading to healthcare costs of $57 billion a year, on par with cancer, according to a 2009 AHRQ brief. Despite this impact, and the ACA's provision for behavioral healthcare as an essential health benefit, progress toward total integration of behavioral healthcare into the primary care system has been slow.

2015 Healthcare Benchmarks: Integrating Behavioral Health and Primary Care captures healthcare's efforts to achieve healthcare parity and honor the joint principles of the patient-centered medical home, including a whole person orientation and provision of coordinated and/or integrated care. Click here for more information.

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Infographic: The Impact of Unmet Mental Health Services

July 3rd, 2015 by Melanie Matthews

Sixty percent of Americans with mental illness have unmet needs for the mental healthcare services they need, according to a new infographic by Best Social Work Programs.

The infographic examines the lack of coordination in mental healthcare services, mental health spending per capita and the impact of the lack of mental health treatment options.

2015 Healthcare Benchmarks: Integrating Behavioral Health and Primary CareBehavioral health conditions affect nearly one of five Americans, leading to healthcare costs of $57 billion a year, on par with cancer, according to a 2009 AHRQ brief. Despite this impact, and the ACA's provision for behavioral healthcare as an essential health benefit, progress toward total integration of behavioral healthcare into the primary care system has been slow.

2015 Healthcare Benchmarks: Integrating Behavioral Health and Primary Care captures healthcare's efforts to achieve healthcare parity and honor the joint principles of the patient-centered medical home, including a whole person orientation and provision of coordinated and/or integrated care.

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Behavioral Health Diagnoses Can Inflate Readmissions Rates, Hinder Self-Management

April 9th, 2015 by Cheryl Miller

Preliminary data from a Care Transitions Task Force found that when patients with behavioral health diagnoses are excluded from readmissions rates, those rates fall by nearly 4 percent, says Michelle Schneidermann, MD, task force member and Associate Clinical Professor of Medicine for the division of hospital medicine at the University of California, San Francisco, and Medical Director of the San Francisco Department of Public Health, Medical Respite and Sobering Center. Part of the reason for this is this patient population's inability to follow through on self-management instructions once they leave the hospital.

Question: Among your discharge patients there’s a number of behavioral health diagnoses. Are there any considerations, or challenges to this patient population during care transitions, and any unique follow-up that your organization is doing?

Response: (Dr. Michelle Schneidermann) Yes, this patient population provides a very distinct challenge. The patients are challenged by so many other competing priorities, in addition to having a significant and severe mental health disorder, that it interferes with their ability to organize and follow through with the self-management requirements we place on them when they leave the hospital and their ability to manage chronic illness in general. So, from the patient perspective, it’s incredibly difficult.

From the systems perspective, although we are an integrated network health system, there are limitations on the number of outpatient behavioral healthcare clinics and providers. Plus, we don’t always have providers who are culturally concordant or language concordant, although the network is trying very hard to make that happen.

One of the things we’re working on right now is to tease out what our readmission rate looks like when we pull out all patients who have a behavioral health code. Just initial, very crude, back of the envelope calculations show a significant difference in our readmission rate.

When patients with behavioral health diagnoses are included, our hospital-wide, 30-day all-cause readmission rate is around 12 percent. When you remove patients with the behavioral health diagnosis, the readmission rate goes down to about 8.5 or 9 percent. Again, preliminary data, but it shows you the impact that this patient population has on readmissions and tells the story about the challenges that they personally face when they’re leaving the hospital.

cross-continuum care transitions
Dr. Michelle Schneidermann completed her primary care internal medicine training at UCSF and joined the UCSF faculty in 2003, where she is a member of the Division of Hospital Medicine at San Francisco General Hospital (SFGH). Through her inpatient clinical work and work with ambulatory programs, she has been able to directly witness the successes and challenges of patients’ transitions and generate feedback to the providers and systems that manage their care.

Source: Cross-Continuum Care Transitions: A Standardized Approach to Post-Acute Patient Hand-Offs

Community Linkages Support HCSC’s Holistic Approach to Duals

September 25th, 2014 by Cheryl Miller

Meeting the holistic needs of the individual, and not treating them as a diagnosis has been key to Health Care Services Corporation's (HCSC) work with dual eligibles. Here, Julie Faulhaber, HCSC’s vice president of enterprise Medicaid, describes the organization's innovative use of community care connections to engage the unique challenges of this largely older adult and disabled population in population health management.

Question: What are some examples of HCSC community connections and how do these linkages benefit Medicare-Medicaid beneficiaries?

Julie Faulhaber: Our community connections are really critical to the success of our program. We work with a number of different community agencies in our state: the community mental health centers, the public health agency, and also with those types of agencies that deliver long term care services or have worked with those with mental health concerns.

We work across the board. All of these agencies catch our members, and we try to have relationships with them in order to gain access to our members, for example to better understand the types of services and support that our members truly need and where to access them. That’s been a key component of our program. We also look for community health workers who have backgrounds in the cultural needs of our members, which helps to engage them initially and maintain engagement.

HIN: What are the most common behavioral health issues your duals face and how has HCSC addressed these issues?

Julie Faulhaber: Our members have the full range of behavioral health issues that one would expect in a dual eligible population. Of course, the majority of individuals are experiencing depression and those types of concerns are often in conjunction with some physical disability. Referring back to the previous question on community linkages, we develop relationships with community agencies that support people with mental illness.

Other behavioral health concerns include those agencies that help people with recovery from addiction. We also worked with an integrated team in our own model of people with behavioral health backgrounds as well as our traditional physical healthcare model. That integration has been important for us in meeting the holistic needs of the individual and not treating them as a diagnosis.

dual eligibles care
Julie Faulhaber, vice president, enterprise Medicaid for Health Care Service Corporation (HCSC), a $52 billion health insurance company with 13.2 million members operating in five states, is responsible for the leadership and oversight of HCSC’s Enterprise Medicaid Business. This includes expansion of Medicaid programs across HCSC’s Blue Cross Blue Shield plans in Illinois, Montana, New Mexico and Texas.

Source: Dual Eligibles Care and Service Planning: Integrative Approaches for the Medicare-Medicaid Population

Infographic: Behavioral Health Service Utilization Among Foster Children

August 15th, 2014 by Melanie Matthews

Nearly one in three children within the United States' foster system use behavioral health services, representing only three percent of all children in Medicaid, but 15 percent of those using behavioral health services and 29 percent of Medicaid expenditures for children’s behavioral health services.

This infographic from the Center for Health Care Strategies compares behavioral healthcare use and expense for Medicaid-enrolled children in general versus those in foster care.

Behavioral Health Service Utilization Among Foster Children

Implementing Evidence Based Practices in Behavioral HealthIn this innovative and reader-friendly guide, Implementing Evidence Based Practices in Behavioral Health, leading researchers from the Dartmouth Psychiatric Research Center examine the implementation of evidence-based practices in behavioral health and offer practical strategies for bringing these practices into routine clinical settings. They look at implementation as a specific process, a set of activities and responsibilities designed to successfully launch a practice and integrate it into routine care, using strategies carried out across many levels of an organization and at various stages.

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3 Components of Geriatric Health Management for Dual Eligibles

March 27th, 2014 by Cheryl Miller

When designing care management programs for dual eligibles, you need to recognize the strong connection between the medical, the social and the behavioral, explains Timothy C. Schwab, MD, FACP, former chief medical officer of SCAN Health Plan. Ultimately, you are caring for the individual; one person in charge of the whole program.

I’d like to give a broad overview of the care management model that we’ve been using at SCAN. It begins with assessment care planning and care management. But we see it as a continuum — a cross between very traditional medical care management and traditional social care management. We’ve combined it into a centralized spot we call our ‘geriatric health management program.’

We meld all that into one care management program — the medical, the social, the behavioral. And then we utilize expertise from the medical sides; for instance, for a patient with diabetes, we use our diabetic disease management module by that geriatric care manager. Or for behavioral health issues, we use the behavioral health side of the program. But again, it all focuses on the individual; one person in charge of the whole program.

When you design for the dual eligible population, you can divide the population into those that are frail and disabled as a primary type of program, but also recognize that this is a low income population with multiple complex chronic conditions. Coordination is the critical link between the social and the medical. Incorporating the traditional things like disease management, utilization management, transition management and complex care management is essential, since all of these are very critical and interrelated.

Excerpted from Community Care Connections for Dual Eligibles: Closing Social Gaps to Improve Health Outcomes.

3 CM Qualities That Engage Populations in Telephonic Case Management

February 12th, 2014 by Jessica Fornarotto

Beyond scripts and data, there are three qualities that a case manager should possess to successfully engage populations in telephonic case management, says Jay Hale, director of quality improvement and clinical operations at Carolina Behavioral Health Alliance (CBHA).

We have found that if case managers are more comfortable with a certain illness or population, they tend to engage members better. We are still trying to figure out the nuances within each population. People who have done more child/adolescent work engage parents better than substance abuse recovery individuals do. People that do a significant amount of substance abuse recovery do a better job with that population than with the adult mental health population. There is an X factor or a subdivision with this.

Second, case managers need to be extroverted people who do not mind making the outgoing phone calls. While we need scripts and data to drive our program, the people who make it most successful are the clinicians who are most comfortable engaging those individuals. However, they are the least comfortable with paperwork, which is why we make our paperwork as simple as possible. We want to be sure that they can point and click, and go straight through it. It is one flowing process for them.

Finally, management also supports engagement. It is important to talk to the staff about success stories and what happened that made them successful. They should use it as a learning opportunity for everyone, but also as a celebration opportunity. As long as we can keep case managers enthused about the program they are doing, that enthusiasm comes through in their voice when they are talking to individuals on the phone and it helps them go the extra mile. It helps them with the process of relating to members at the other end.

"At CBHA, we developed our telephonic case management program to find a way to support and improve the care of some of our most vulnerable members. We want to be good stewards of the monies that are given to us by our client companies to pay for their behavioral health claims," said Jay Hale.

Excerpted from: Telephonic Case Management Protocols to Engage Vulnerable Populations