Transcript InAHQ_Advancing Behavioral Health in Indiana Presentation_May

Advancing Behavioral Health in Indiana
Teasa Thompson, MPH
May 13, 2016
Qsource - Who we are and What we do
We are Contracted by the Centers for
Medicare & Medicaid Services (CMS)
Change agents focused on three aims:
• Better care
• Smarter Spending
• Healthier People
Partner with patients, providers, and
practitioners across five states to conduct
quality improvement activities that put
patients first and equip providers to do the
same.
2
Qsource - Who we are and What we do
Committed to:
• promoting effective prevention and treatment of chronic disease by
•
•
•
promoting safe care that is patient and family-centered, reliable and
accessible
making care safer and reducing harm caused in the delivery of care
promoting effective communication and coordination of care
making care more affordable
Skilled in:
• creating opportunities for providers to learn from each other,
• applying advanced improvement and analytical methods,
• structuring processes for sustaining positive change
3
QIN-QIOs Across the Country
4
atom Alliance Partners
Multi-state alliance for powerful
change composed of three
nonprofit, healthcare QI consulting
companies
5
The Process
6
Aims of the Behavioral Health Initiative
Provide technical assistance and education interventions to:
Increase rates of behavioral health screening
Increase outpatient follow-up
Reduce readmission
Primary Care Practices:
Increase physician/provider rates of behavioral health screening for depression
and alcohol abuse
Improve referral for behavioral health services
Inpatient Psychiatric Facilities:
Reduce 30-day readmission rate
Increase follow up rate post discharge
Goals:
10,000 practices will screen a majority of their Medicare population for
depression and alcohol abuse
1.5 million beneficiaries will be screened by 2019.
7
Why is Advancing Behavioral Health
Important?
Approximately 6.7 percent of
American adults−about 14.8 million
people−live with major depression.
About 9.2 million adults have cooccurring mental health and addiction
disorders.
Additionally, challenges in effective
care coordination for these and other
behavioral health conditions contribute
to high hospital readmission rates and
problems with treatment adherence.
8
Why is Advancing Behavioral Health
Important?
Physicians screen fewer than half of their patients for alcohol
use disorders
Roughly two-thirds of those with a behavioral health disorder do
not get behavioral health treatment
Depression is identified in fewer than half of primary care
patients
Depression and alcohol use disorder are common behavioral
health conditions in adults, yet they are often under-identified in
primary care settings.
9
Behavioral Health and Primary Care
Behavioral Health and Primary Care
68% of adults with
BH conditions have
medical and 29% of
adults with medical
conditions have BH
How We Will Advance Behavioral Health?
By Partnering with
Primary Care Practices
& Inpatient Psychiatric Facilities
12
Alliance Partner Participation
13
Behavioral Health Initiative in Indiana
Statewide
Primary Care Practices
• Over 280
Inpatient Psychiatric Facilities
• 14
14
Challenges?
The atom Alliance recognizes that there are
challenges that practices face in the effort to integrate
behavioral health in the primary care setting:
• limited BH referral resources
• lack of BH training
• competing priorities
15
atom Alliance can be part of the
Solution!
Access to:
Industry best practices
Healthcare and Integration expertise
Cherokee Health Systems (CHS) and
Medical Decision Logic, Inc.© (mdlogix)
Overall value to our partners
16
atom Alliance can be part of the
Solution!
Partner with Primary Care Providers to implement and/or improve the
use of depression and alcohol screeners in the primary care setting
Provide technical and clinical assistance in the integration of
behavioral screeners into the current HIT capabilities and practice
workflows
Provide verified depression and alcohol screeners (e.g. PHQ9,
AUDIT C) in the practice’s chosen format (i.e. integrated into EHR,
included in patient packet, etc.)
17
Screening Tools
Evidence-based
Common Examples:
Alcohol Misuse Screening
• CAGE AID –5 items
• AUDIT-C –3 items
Depression Screening
• Patient Health Questionnaire (PHQ)
• PHQ-2 –preliminary screening
• PHQ-9 –additional screening if PHQ-2 is positive
18
19
atom Alliance can be part of the
Solution!
Assess the practice’s Behavioral Health neighborhood to identify
referral sources and build a robust BH referral network
Provide ongoing educational and learning opportunities for practice
staff including CEU’s
Provide “office hours” for providers to call with questions
20
atom Alliance can be part of the
Solution!
Return on Investment (ROI)
Financial
• Access to experts, education, and resources paid for by CMS
• ROI average screening reimbursement rates are $16 per
patient, multiplied by the number of patients seen per practices
Qualitative- Improved patient care
• Protection for clinicians –Not knowing a patient has behavioral health or
substance use risks can increase risk for the clinician, such as prescribing
medications that may be contraindicated
Access to data from atom Alliance
21
Technical Approach
22
Technical Assistance
Provide health literacy and educational tools for beneficiaries
Offer LAN meetings where peer-to-peer learning of best
practices and success stories can be shared
Assist with processes and procedures that will increase quality
across all Qsource/atom Alliance initiatives.
23
Stakeholder Participation
Our BH community stakeholders are key partners in the work to
advance integrated and coordinated BH care in our communities.
atom Alliance’s stakeholder partners are involved in the work of
advocating for patients, reducing the stigma of BH conditions and
providing additional supports to the BH neighborhood.
Our stakeholders bring to this task work expertise in various areas
concerning BH and will enrich and enlighten the work that we do.
In this collaboration it is our goal to provide mutual support and
advance the shared goals that we have.
24
atom Alliance can be part of the Solution!
Building the Behavioral Health Neighborhood
Care Coordination Communities:
• Implement evidence-based interventions to reduce
hospital admissions and readmissions
• Track changes and progress using real-time and claimsbased
• Redesign workflow, to improve care coordination between
facilities
• Assemble, lead or contribute to care coordination
communities
25
atom Alliance can be part of the Solution!
help communities by:
Assisting facilities and communities in selecting measures
for quality reporting
Preparing data feedback reports and providing technical
assistance
Sharing collective tools and resources
Supporting and promoting community meetings and care
coordination activities
Hosting on-site and virtual learning events
26
Other Qsource/atom Alliance Initiatives
Improving Cardiac Health & Reducing
Disparities
We assist home health agencies, physician offices, clinics
and others spread the use of evidence-based practices to
promote the “Cardiac ABCS” and support the Million
Hearts initiative.
Reducing Disparities in Diabetes Care
Diabetes Self management Education (DSME) is a
proven intervention for empowering persons with diabetes
to acquire the knowledge and skills necessary to improve
the quality of their lives.
Prevention Coordination through
Meaningful Use
We collaborate with Regional Extension Centers (RECs)
to showcase proven interventions that result in primary
care providers successfully meeting the requirements of
the Medicare Electronic Health Record (EHR) Incentive
Program.
Reducing Healthcare-Associated
Infections
Using evidence-based strategies to prevent healthcareassociated infections (HAIs) can increase the quality of
patient care, save lives and decrease healthcare costs.
Reducing Healthcare-Acquired
Conditions
27
We are uniting nursing homes in a powerful collaborative
to share tools, knowledge and experiences for improving
resident safety and clinical processes and reducing
preventable healthcare conditions.
Coordination of Care
We are bringing together statewide communities to create
powerful collaborations of change that promote the
seamless coordination of care for older adults.
Value-Based Payment, Quality Reporting
& Physician Feedback
We help healthcare providers assess clinical quality of
care, care coordination, patient safety, and much more to
meet CMS quality reporting and value-based payment
requirements.
Improving Immunization Rates
Historically, immunization rates among adults have been
low. atom Alliance aims to change that by working with
practitioners, providers, and beneficiaries.
Transforming Clinical Practice
We collaborate to assist clinicians in changing the way
they deliver care, to better position for success in the
healthcare market for the future; one that rewards value
and outcomes rather than volume.
Resources
Helpful Links
atomalliance.org/initiatives/behavioral-health/
mdlogix.com/
cherokeehealth.com/
integration.samhsa.gov/clinical-practice/screening-tools
cms.gov/Medicare/Prevention/PrevntionGenInfo/Downloads/MPS_
QuickReferenceChart_1.pdf
cms.gov/Medicare/Prevention/PrevntionGenInfo/Downloads/MPSQuickReferenceChart-1TextOnly.pdf
28
atom Alliance Behavioral Health Team
29
Contact Information
Teasa Thompson, MPH
Phone: (317) 864-9732
Email: [email protected] or [email protected]
Indiana Office:
911 E. 86th Street, Suite 202, Indianapolis, IN 46204
30
Questions
31