Treating the mind and body. 3 questions to consider when linking physical and behavioral health services

Transcription

1 Treating the mind and body 3 questions to consider when linking physical and behavioral health services

2 Healthcare systems with a foundation of effective primary care are more likely to improve population health outcomes and reduce per-capita expenditures. What are the building blocks of an effective primary care foundation? Accessible care Long-lasting patient relationships Comprehensive services Thorough care coordination throughout the entire healthcare system

3 Whole Person Care One way to improve the value of primary care is to integrate physical and mental health services within your healthcare system. This approach supports whole person care that is, the coordination of clinical and behavioral health services. Whole person care increases the following: Access to community services Consumer engagement Reliance on primary care providers Positive outcomes It decreases: Potentially preventable readmissions Total cost of care Use of unnecessary services Whole person care How does it work? Consider this scenario: A patient with chest pain sees a primary care physician and cardiologist then goes to the emergency department and urgent care clinic before learning that the chest pain is a manifestation of his or her anxiety disorder. Integrated services could have reduced the uncoordinated, unnecessary and costly procedures for this patient. If a mental health specialist, for example, was available for immediate consultation in a primary care practice, the specialist could have intervened to identify the root cause of the chest pain. As a result, the specialist could have also created a coordinated treatment plan.

4 As you think about linking physical and behavioral health services, consider these three questions: 1 Why is it important to integrate physical and behavioral health services? 2 What s the most effective way to integrate care delivery? 3 How can you structure a plan for whole person care?

5 1 Why is it important to integrate physical and behavioral health services? Without integration, patients may not receive timely, comprehensive and coordinated care. A lack of integration also leads to split budgets, disjointed quality measurements and isolated policies that don t streamline care coordination. 29% of adults with medical conditions also have mental health conditions 1 68% of adults with mental health conditions also have medical conditions 1

6 2 What s the most effective way to integrate care delivery? Healthcare systems need a robust methodology to assess the total illness burden of their members so they can create a segmentation strategy that includes both physical and mental health status. Total illness burden methodologies enable healthcare systems to place each patient into a uniform category of expected resource utilization. This helps create condition- and severity-specific budgets for expected care needs. Methodologies such as 3M Clinical Risk Groups make it possible to include patients with lower-severity/lower-intensity diagnoses in a prepaid plan with the expectation that systems will budget for and address the full spectrum of needs for these patients.

7 3 How can you structure a plan for whole person care? Consider these suggestions when structuring a plan for whole person care: Establish capitation rates for special-needs populations by using reliable, categorical risk-adjustment methods that account for the interactions among physical, behavioral and functional health status. Understanding these interactions can highlight significant differences in patient needs. Knowing this can also help prevent inadequate payment rates that may limit a provider s ability to deliver high-quality care. Ensure sound data feeds. Collecting and reporting functional and behavioral health status can be highly variable, which is why data collection standards must be clear. Clear and consistent collection methods help guarantee the quality of incoming data. Focus on quality not cost reduction. Overly-aggressive approaches to reduce costs may not be successful, particularly in the initial stages of an integrated approach. As proper integrated risk-adjusted methods are implemented over time, providers will realize financial benefits more clearly. A gain share approach, guided by high-quality measures, will help push the healthcare system toward more efficient care. The goal of whole person care is improved beneficiary health and well-being through more efficient and effective resource utilization.

8 How does 3M Health Information Systems support whole person care? 3M provides the consulting, analytics and software tools to help you: Accurately define your population s total illness burden by assessing each patient s functional and mental health status Identify and address non-medical factors to help prevent poor outcomes Identify high-risk patients using predictive analytic models Prospectively predict patient resource utilization Segment patients with similar needs so physicians can create interventions to improve outcomes Track quality outcomes to see determine the impact of an integrated care approach Call today Learn how 3M s innovative approaches to link physical and behavioral health can help you successfully provide whole person care. Call Or, dig into some more information at

9 Footnotes 1. Alegria M, Jackson JS, Kessler RC, Takeuchi D. National Comorbidity Survey Replication (NCS-R), Ann Arbor: Inter-university Consortium for Political and Social Research, Health Information Systems 575 West Murray Boulevard Salt Lake City, UT U.S.A M is a trademark of 3M Company. Please recycle. Printed in U.S.A. 3M All rights reserved. Published 10/