NATIONAL HEALTH CARE REFORM

Transcription

1 MACMHB Conference February 2015 NATIONAL HEALTH CARE REFORM Oh no not again but then again change is good right? 1

2 Are we preparing? or Northwest Michigan Health Services Crystal Lake Health Center Centra Wellness Network Catholic Human Services NORTHERN MICHIGAN HEALTH COALITION Michigan Community Dental Clinics West Shore Hospital Health Dept. District #10 Benzie-Leelanau Health Dept. Area Agency on Aging 2

3 Primary care Acute physical care Specialty physical care Public health Lab Mental health care Substance use treatment Dental care Elder care Wellness education Northern Michigan Health Coalition VISION State-of-the-Art regional integrated health care system Community members, with or without health insurance, of all social strata and walks of life will receive health care that is affordable easily accessible and friendly high quality holistic wellness oriented Northern Michigan Health Coalition 3

4 VISION Care for the whole patient and manage multiple, interrelated and chronic health problems Collaborate to provide a range of health care services to people of all ages and Align our clinical and financial incentives to meet 1. improved quality 2. improved patient experience 3. reduced costs Northern Michigan Health Coalition Integration Primary care is king Ingemar Johansson, MBCMH Integration 4

5 Centra Wellness MH Therapist embedded at: Crystal Lake Clinic in Benzonia and Interlochen (private) West Shore Medical Center Primary Care clinic (county hospital) Integration Centra Wellness MH Therapist: Referrals from primary care providers Mental health assessments Referrals to other appropriate providers Limited therapy Coordinates treatment with PCPs Documents in clinical records of PCP (at this time) Integration Crystal Lake Clinic primary care Centra Wellness Network behavioral health care Catholic Human Services substance use treatment West Shore Medical Center lab, imaging, PT Who Manistee will get voted Wellness off the Center island? 5

6 Who Manistee will get voted Wellness off the Center island? Who Manistee will get voted Wellness off the Center island? Who Manistee will get voted Wellness off the Center island? 6

7 Shared functions Parking lot Waiting room Reception Meeting rooms Break room etc. Relationships Collegiality Lots of curbside consultations in all directions The huddle Who Manistee will get voted Wellness off the Center island? Michigan Medicaid Health Home pilot project (ACA section 2703) Who is eligible? People that have a serious mental illness andat least one other chronic health conditions and at least 2 visits to a hospital/er within the last 18 months 7

8 Covered services Care management Care coordination Health promotion Transitional care (inpatient out) Individual and family supports Referrals Added functions Officially: Health Home Director Primary Care Liaison RN Care Manager Unofficially: Data specialist Support staff To the tune of $138 per enrollee per month 8

9 Opportunity to change our paradigm in the new world of health care RN Care Manager Health assessment Health plan development (quasi common treatment plan) Care coordination Health promotion Family supports Transitional care (inpatient out) Referrals Tuesday morning huddle Clinical integration 9

10 Tuesday morning huddle Psychiatrist Primary Care Provider RN Care Manager ER staff (hospital) Case Managers Therapists Therapist Supervisor Team facilitator Clinical integration Tuesday morning huddle 8 am for 30 minutes sharp Cover about 6 8 patients (focus on Health Home enrollees) Discuss patients that have psychiatric appointments the upcoming week 8 am for 30 minutes sharp Clinical integration Integration project Phase 1: 53% of all CentraWellness consumers also served by Crystal Lake Clinic (primary care) Phase 2: Process of regular update reports Clinical integration 10

11 Integration project Phase 3: Shared scheduling system Visit primary care and psychiatrist/therapist in one visit Give updated demographic information only once = Improved patient experience Clinical integration Integration project Daily ER admissions reports Clinical integration Integration project Separate electronic health records (actually across our whole coalition) IT 11

12 Integrated Electronic Health Record Integration project Health Information Exchange Longitudinal information (shared patient information) Analytical information (population management) IT Consent to share patient information IT 12

13 What are we not doing yet? But we know that we want metrics universal health plan daily huddle with all providers universal scheduler health information exchange complete ADT notifications IngemarJohansson COO at Centra Wellness Network Chair at Northern Michigan Health Coalition