Hospital Diversion Strategies. Jeff Richardson Mosaic Community Services

Transcription

1 Hospital Diversion Strategies Jeff Richardson Mosaic Community Services

2 Mosaic Community Services 28,000 consumers a year with mental health and substance use needs (adults, children, and families) 700 staff Central Maryland 120 Locations

3 Behavioral Health and Primary Care Are Inseparable BH disorders account for half as many disability days as all physical conditions Annual medical expenses--chronic medical & behavioral health conditions combined cost 46% more than those with only a chronic medical condition Top five conditions driving overall health cost (work related productivity + medical + pharmacy cost) Depression Obesity Arthritis Back/Neck Pain Anxiety Persons with serious mental illness (SMI) are dying earlier than the general population (average age of death is 53) While suicide and injury account for about 30-40% of excess mortality, 60% of premature deaths in persons with schizophrenia are due to medical conditions such as cardiovascular, pulmonary and infectious diseases (NASMHPD, 2006) Oregon study found that those with co-occurring MH/SU disorders were at greatest risk (45.1 years)

4 Individuals with behavioral health conditions frequently have co-occurring physical health conditions. Chart 2: Percentage of Adults with Mental Health Conditions and/or Medical Conditions, Adults with Mental Health Conditions Adults with Medical Conditions 29% of Adults with Medical Conditions Also Have Mental Health Conditions 68% of Adults with Mental Health Conditions Also Have Medical Conditions Source: Druss, B.G., and Walker, E.R. (February 2011). Mental Disorders and Medical Comorbidity. Research Synthesis Report No. 21. Princeton, NJ: The Robert Wood Johnson Foundation.

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6 The presence of a mental health disorder raises treatment costs for chronic medical conditions. Chart 3: Monthly Health Care Expenditures for Chronic Conditions, with and without Comorbid Depression, 2005 Source: Melek, S., and Norris, D. (2008). Chronic Conditions and Comorbid Psychological Disorders. Cited in: Druss, B.G., and Walker, E.R. (February 2011). Mental Disorders and Medical Comorbidity. Research Synthesis Report No. 21. Princeton, NJ: The Robert Wood Johnson Foundation.

7 Coordination of care can reduce costs for individuals with behavioral health conditions. Chart 9: Total Costs at 1 and 2 Years for Patients with Serious and Persistent Mental Illnesses Receiving a Medical Care Management Intervention vs. Usual Care Source: Druss, B.G., et al. (2011). Budget Impact and Sustainability of Medical Care Management for Persons with Serious Mental Illness. American Journal of Psychiatry, AiA, 1-8.

8 Mosaic Current Integrated Care Strategies Medical Day Care Co-location Reverse Co-location Consultation services Wellness and health initiatives Provider partnerships Academic partnerships Center for Integrated Health Solutions Tele-psychiatry Electronic Health Record

9 Mosaic Integrated Health-Reverse Co- Location Reverse Co-location model - Somatic Care Provider may be in a psychiatric specialty setting to monitor the physical health of patients. This model has been shown to reduce ER visits by 42%. Providing at risk patients with identifying healthcare risks through direct services, education and collaboration with psychiatric treatment team. Priority Population: untreated medical conditions and individuals who have co-occurring mental health and substance abuse disorders.

10 Results 300 consumers By self-report, one year prior to MIH intake there were 759 somatic and psychiatric ED visits, decreased after intake to 35 somatic and psychiatric ED visits.

11 Residential Crisis Services Program serves adults experiencing a mental health crisis. The program functions as an alternative to hospitalization or as emergency room diversion Discharged from inpatient psychiatric hospitalization who are not ready to return to community living. Primary Care coordination

12 Key Statistics 55% dual diagnosis 40% uninsured 68% of homeless consumers moved to permanent housing 9% readmitted for psych hospitalizations

13 Resources Center for Integrated Health Solutions Jeff Richardson Twitter