Cathy Francis, PsyD, MFT St. Joseph s Behavioral Health Center

Transcription

1 Breathing New Life into Partial Hospitalization Programs Cathy Francis, PsyD, MFT St. Joseph s Behavioral Health Center 1

2 Breathing New Life into Partial Hospitalization Programs Presented by: Cathy Francis, PsyD, MFT Director of Social Services St. Joseph s Behavioral Health Center Why are Partial Hospitalization Programs important in the continuum of care... Sara s Story 4 2

3 The Future for Partial Hospitalization Programs Obstacles patients face in getting into a PHP 1. Limited # of PHPs 5 History of Partial Hospitalization Programs In 1963 Congress signed the Community Mental Health Act This act requires PHP to be one of the care services provided by Community Mental Health Clinics In 1980 there were over 1600 PHPs in the United States In 2014 there were less than 500 PHPs in the United States The number of PHPs have declined due to: Fraudulent billing practices More stringent regulatory requirements 6 3

4 Partial Hospitalization Programs in Northern California 7 Partial Hospitalization Programs in Southern California 8 4

5 The Future for Partial Hospitalization Programs Obstacles patients face in getting into a PHP 1. Limited # of PHPs 2. Medicare reimbursement is decreasing 9 Medicare Reimbursement Rates Mean Cost Reimbursement Rate Reimbursement Rate Reimbursement Rate CMHC PHP $ $ $ $ Hospital PHP $ $ $ $

6 The Future for Partial Hospitalization Programs Obstacles patients face in getting into a PHP 1. Limited # of PHPs 2. Medicare reimbursement is decreasing 3. Insurance companies are changing criteria for admissions 4. Regulatory scrutiny 5. History of fraud and abuse 11 Literature Review and Research Project Limited number of studies done on the effectiveness of PHPs Numerous ways to suggest effectiveness 1. Lower Readmission Rates to an inpatient setting 2. Patient and Family satisfaction 3. Lower health care related costs 4. Improved functional status of patient treated in the program 12 6

7 Literature Review and Research Project (cont.) Limitations in the studies reviewed 1. Inadequate program descriptions 2. Small sample sizes 3. Non-random assignments 4. Non-standardized response measures 13 Research Project Study readmission rates in a single hospital system and length of stay for patients who were readmitted after attending a PHP 14 7

8 Findings 15 Limitations of the Research Review of singular hospital system Underestimated readmission number Lack of other studies to support my assumption 16 8

9 Recommendations for Research More studies looking at the effectiveness of PHPs Studies focusing on multiple hospitals data in regards to readmission rates Additional studies looking at the difference between IP and PHP level of care as well as PHP and IOP level of care 17 Hospital Based Services and Non-Hospital Based Services in San Joaquin County Private Insurance and Medicare Clients Inpatient Crisis stabilization PHP Learn skills IOP Learn how to implement new skills into daily living Private Practitioners Relapse prevention & skill acquisition Medical and Clients with no insurance Inpatient (16-bed) crisis stabilization Post PHF Clinic Psychiatric Health Facility Weekly Outpatient Intake Appointment Outpatient Psychiatrist Appointment Now the patient is open to outpatient services 18 9

10 Top 10 things you can do in 2016 to breathe new life into Partial Hospitalization Programs 1. Advocate to increase Medicare reimbursement rates 2. Publish a study on the effectiveness of Partial Hospitalization Programs 3. Work with insurance companies to promote consistent criteria for PHPs 4. Advocate to start patients in PHP instead of inpatient or step inpatients down to PHP instead of IOP 5. Stay current on provider rights and federal mental health parity (connect with DMHC) 19 Top 10 things you can do in 2016 to breathe new life into Partial Hospitalization Programs (cont.) 6. Develop outcomes data for your programs 7. Encourage patients to tell their stories and set up meetings with outpatient providers in your organization to discuss PHP 8. Meet with your County mental health director and address gaps in the continuum of care 9. Join the Association of Ambulatory Behavioral Health 10. Educate clients about their rights 20 10

11 Questions? Thank you Cathy Francis, PsyD, MFT St. Joseph s Behavioral Health Center (209) cathy.francis@dignityhealth.org 11