Intervention Models: Innovation, Collaboration & Implementation. Andrew Bertagnolli, PhD Kent Corso, PsyD, BCBA-D Cathie Fox, PhD

Transcription

1 Intervention Models: Innovation, Collaboration & Implementation Andrew Bertagnolli, PhD Kent Corso, PsyD, BCBA-D Cathie Fox, PhD

2 Overview Introductions Discussion of Key Issues Questions & Answers Fifth Agenda

3 Disclosure Statement Andrew Bertagnolli, PhD has nothing to disclose Kent Corso, PsyD BCBA-D discloses a potential conflict of interest related to book sales Cathie Fox, PhD has nothing to disclose Fifth Agenda

4 Fast Facts 7 Regions 190,000 Physicians & Staff 7,800 Behavioral Health Clinicians 607 Medical Offices & Hospitals 10.1 Million Members

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6 Implement a suite of solutions with an overriding theme of integrating primary care with behavioral health in a bi-directional manner. Primary Care Setting Guided Self-Help Skills Building Telephone Based Coaching Specialty Behavioral Health Setting Inpatient, Intensive Outpatient and Crisis Services Medication Management Medication Management Individual & Group Therapy Integrated Behavioral Health Clinician Case Management Nurse Care Management Skills Training Near-Real-Time Psychiatric Medication Consultation Tele-Behavioral Health & Internet Based Care Where Appropriate Peer Based Education & Support Connection with Community Resources

7 NCR Behavioral Health WE PROVIDE: consultation training program development, evaluation and improvement FOR: hospitals private practices healthcare organizations corporate wellness programs TO YIELD: cost-saving and quality-enhancing integrated behavioral health programs

8 NCR Behavioral Health Prior clients: federal government; private healthcare organizations in the U.S. and Canada Department of Defense (DoD): National Capital Region Medical Directorate 232,000 patients/beneficiaries 12 programs including primary care behavioral health and care management models Generated 18 peer-reviewed manuscripts on primary care behavioral health Trained for over 650 primary care providers, psychology interns, social work interns, psychiatric nurse pratitioners, registered nurses, licensed psychologists and social workers

9 Highly Integrated Health System Hospitals Since hospitals 2,784 licensed beds Our Charge: To help people live the SelectHealth healthiest lives possible Since 1983 Health plans 700,000+ members Medical Group Since ,200 employed physicians 558 advanced practice clinicians Clinical Programs Since key service lines

10 Culture of a Learning Healthcare System Common Vision Clinical Work Processes Data and Evaluation Transparency

11 Mental Health Integration (CPM) provides evidence based team approach and tools for caring for patients/persons and families. What is Mental Health Integration? Essential Integrated Elements A standardized clinical and operational team relational process that incorporates mental health as a complementary component of wellness & healing Leadership and culture champions establishing a core value of accountable and cooperative relationships Workflow engaging patients on the team and matching their complexity and need to the right level of support Information systems EMR, EDW, registries, dashboard to support team communication and outcome tracking Financing and operations projecting, budgeting and sustaining team FTE to measure the ROI Community resources who are our community partners to help us engage our population in sustaining wellness 12

12 Our framework for Mental Health Integration is focused on clinical quality, the patient experience and decreasing overall costs. Strategy : Mental Health Integration A team approach to clinics. Integration Personalized Primary Care Community Resources Care Manager Health Advocates Psychiatrist or Psychiatric NP Therapist (Psychologist, LCSW, EAP) Peer Mentor Our Families & Patients Specialty Care NAMI Community Therapists Physical Therapists Nutritionist Clinic Manager Clinical Staff (RN, MA, Reception, Billing) Pharmacists Information Technology / EMR / Data / TeleServices 13

13 Key Considerations for Integrated Care Culture Specialty Behavioral Health vs Primary Care Psychology Models of Care Co-location, Integrated, & Consultative Personnel & Systems Staff Selection, Training, On-going Support, System Support Patients Identification of appropriate patients Accountability Coding, Billing, Productivity & Costs

14 Key Considerations for Integrated Care Culture Specialty Behavioral Health vs Primary Care Psychology Models of Care Co-location, Integrated, & Consultative Personnel & Systems Staff Selection, Training, On-going Support, System Support Patients Identification of appropriate patients Accountability Coding, Billing, Productivity & Costs

15 Key Considerations for Integrated Care Culture Specialty Behavioral Health vs Primary Care Psychology Models of Care Co-location, Integrated, & Consultative Personnel & Systems Staff Selection, Training, On-going Support, System Support Patients Identification of appropriate patients Accountability Coding, Billing, Productivity & Costs

16 Key Considerations for Integrated Care Culture Specialty Behavioral Health vs Primary Care Psychology Models of Care Co-location, Integrated, & Consultative Personnel & Systems Staff Selection, Training, On-going Support, System Support Patients Identification of appropriate patients Accountability Coding, Billing, Productivity & Costs

17 Key Considerations for Integrated Care Culture Specialty Behavioral Health vs Primary Care Psychology Models of Care Co-location, Integrated, & Consultative Personnel & Systems Staff Selection, Training, On-going Support, System Support Patients Identification of appropriate patients Accountability Coding, Billing, Productivity & Costs

18 Key Considerations for Integrated Care Culture Specialty Behavioral Health vs Primary Care Psychology Models of Care Co-location, Integrated, & Consultative Personnel & Systems Staff Selection, Training, On-going Support, System Support Patients Identification of appropriate patients Accountability Coding, Billing, Productivity & Costs

19 Questions

20 Recommended Readings Behavioral Consultation and Primary Care (Robinson and Reiter,2007) Integrated Behavioral Health in Primary Care: Step- By-Step Guidance for Assessment and Intervention (Hunter, Goodie, Oordt & Dobmeyer, 2009) Integration of Behavioral Health into Medical Homes: A Rapid Implementation Guide (Corso, Hunter, Dahl, Kallenberg & Manson, in press)

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