Welcome to the third edition of the CFHA News and Research Column, a new series of posts that highlight recent developments in the field of collaborative and integrated care. Check back in the future for additional reports.
European Countries Designing Large Collaborative Care System
Multiple chronic conditions make medical treatment more difficult for physicians. A new cloud infrastructure in Europe will span across 12 partners in seven countries to provide personalized treatment plans for each patient. Hospitals, general practitioners, and social care organizations across the system will be able to exchange information and coordinate care more effectively. The hope is that new models of patient-centered, integrated care will emerge to reduce admissions and costs. The project is funded by EU Horizon 2020 and supported by the Institute of Digital Healthcare, based at the University of Warwick.
The New Hampshire Integrated Care Medicaid Waiver
The Centers for Medicare and Medicaid Services recently approved New Hampshire’s Medicaid waiver for a "sustainable integrated care system”. This new system will serve all Medicaid beneficiaries and will progressively move payments to more outcome-based measures. The goal is to build capacity for transforming behavioral health care services in the state for Medcaid beneficiaries. Program evaluation will focus on the following five performance measures:
1. Quality of care delivered to individuals with co-occurring physical and behavioral health issues
2. Total cost of care for Medicaid beneficiaries with co-occurring physical and behavioral health issues
3. Rate of avoidable re-hospitalizations for individuals with co-occurring physical and behavioral health issues
4. Percentage of Medicaid beneficiaries waiting for inpatient psychiatric care
5. Average wait times for outpatient appointments at community mental health centers
Health is Primary Campaign Focuses on Integrated Care during Month of May
For the past several weeks, the Health is Primary campaign from Family Medicine for America’s Health focused its efforts in May on promoting mental health and its integration into primary care. As part of this effort, campaign workers released a mental health tear sheet that physicians can distribute to patients.
Benefits of Medicaid Expansion for Behavioral Health: DHHS Issues a Report
Under the direction of the U.S. Department of Health and Human Services, the Office of the Assistant Secretary for Planning and Evaluation recently released a brief that analyzes national data on behavioral health including the impact of Medicaid expansion under the Affordable Care Act. Here are some key points:
· Many of those who could benefit from Medicaid expansion have behavioral health needs.
· In states that have not yet expanded, Medicaid expansion would provide considerable benefits for individuals with behavioral health needs and their communities.
· Access to appropriate treatment results in better health outcomes.
· States that choose to expand Medicaid may achieve significant improvement in their behavioral health programs without incurring new costs.
· Medicaid expansion also reduces costs that are incurred by state and local governments and state economies as a consequence of behavioral health problems.
· Across the globe:
o Call for major mental health reform in Australia
oCost-utility of collaborative care for major depressive disorder in primary care in Netherlands sample
oIntegrated care for homeless populations in Canada
oCall for mental health reform in Portugal including collaborative care
oCollaborative care is clinically and financially effective in England sample
· Patients prefer substance abuse treatment in primary care compared to specialty treatment centers according to a study at Johns Hopkins Bloomberg School of Public Health.
·Physicians in the Henry Ford System believe that integrated care is satisfying, improves patient care, is a needed service, and reduces personal stress level.
· Tele-health service based on non-clinically trained health advisers supporting patients in use of internet resources was effective compared to usual care in a randomized, controlled trial.