Preparing for New Hampshire Behavioral Health Summit December 3, 2015
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1 Preparing for 2016 New Hampshire Behavioral Health Summit December 3, 2015
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5 9.3 million more Americans have insurance Uninsured rate down to 11.9% Health spending historically low growth rate 3.7% 27 states + DC expanded Medicaid 5
6 Service and Payment Redesign Contain cost and improve quality by Reducing hospital care and unnecessary treatments Integrating and connecting care And focusing on high user populations
7 Appetite for Experimentation = Opportunity Accountable Care Organizations (ACOs) and Value Based Payment Dual Eligible Projects Medical/Health Homes State Medicaid Waivers
8 Key Ingredients Real time information sharing Interdisciplinary care teams High performing provider networks Strong quality management systems Aligned financial incentives
9 Some Progress but Treatment Problems Ten leading causes of death - only one, suicide going up Brain the last frontier 6 /10 receive NO MH CARE More treated in primary care - 30 million get prescription for psychiatric medication Of course you feel great. These things are loaded with antidepressants.
10 Untreated mental health conditions in primary care and Untreated medical conditions in specialty care
11 11 Prescription Drug/Opioid Abuse: We have an epidemic
12 HHS Initiative to Decrease Opioid Overdoses On March 26, 2015, the U.S. Department of Health and Human Services announced a targeted initiative to decrease opioid overdoses, decrease overall overdose mortality, and decrease the prevalence of opioid use disorder. The Secretary s initiative targets three priority areas to combat opioid abuse: Opioid prescribing practices to reduce opioid use disorders and overdose Expanded use and distribution of naloxone Expansion of MAT to reduce opioid use disorders and overdose.
13 Policy in Support of Better Care
14 Mental Health and Substance Use Legislation in the 114 th Congress Mental Health First Aid Act (S. 711/H.R. 1877) Comprehensive Addiction and Recovery Act (S. 524, H.R. 953) Mental Health Access Improvement Act of 2015 (S. 1830/H.R ) The Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2015 (S. 1134) Medicare Formulary Improvement Act of 2015 (S. 648) The Safer Prescribing of Controlled Substances Act of 2015 (S. 1392) The Opioid Overdose Reduction Act of 2015 (S.707) The Treatment and Recovery Act (S. 1410) The Second Chance Reauthorization Act of 2015 (S. 1513) The Breaking Addiction Act (H.R. 1988) Stop Overdose Stat Act of 2015 (H.R. 2850) The Opioid Addiction Treatment Modernization Act (H.R. 2872) The Safe, Accountable, Fair and Effective (SAFE) Justice Act (H.R. 2944) The Increasing the Safety of Prescription Drug Use Act (S. 636) The Supporting Positive Outcomes After Release Act of 2015 (S. 1409) The Helping Families in Mental Health Crisis Act (H.R. 2646) The Mental Health Reform Act (S. 1945) The Mental Health Awareness and Improvement Act (S. 1893) The Mental Health and Safe Communities Act (S. 2002) The ServicememberAssistance for Lawful Understanding, Over 30 bills introduced so far in the 114 th Congress.
15 Rep. Tim Murphy bill Helping Families in Mental Health Crisis Act (H.R. 2646) Sens. Murphy/Cassidy bill Mental Health Reform Act (S. 1945) HELP Committee bill (Murray-Alexander) Mental Health Awareness and Improvement Act (S. 1893) Cornyn bill Mental Health and Safe Communities Act (S. 2002)
16 Certified Community Behavioral Health Clinics Securing the Safety Net
17 Two Roles of Behavioral Health Providers in the New Health Ecosystem Behavioral health inside medical homes deeply embedded in primary care team, prevention and early intervention, addressing behaviors as well as disorders Behavioral health specialty centers of excellence, partnering with medical homes to provide highvalue, whole-health care to people with complex conditions CCBHCs
18 CCBHC Scope of Services Screening, Assessment, Diagnosis Pt. Centered Treatment Planning Outpatient MH/SA Crisis Services* Mobile Emergency Crisis stabilization Peer Support Psychiatric Rehab Targeted Case Management Primary Health Screening & Monitoring Armed Forces and Veteran s Services Delivered directly by CCBHC Delivered by CCBHC or a Designated Collaborating Organization (DCO)
19 Behavioral Health IT Act Let me in! Behavioral health provider Meaningful Use Incentive Program
20 Comprehensive Addiction Treatment Act (S.524/H.R.953) Treatment and Recovery Act (S.1410) Supporting Positive Outcomes After Release Act (S.1409) Safe Prescribing of Controlled Substances Act (S.1392)
21 Medicaid Managed Care Proposed Regulations Network adequacy (Plans must ensure they have sufficient providers in their networks, including BH providers) Health IT (Plans must build into their capitated rates the costs of helping providers adopt EHRs/other HIT)
22 What Else Can We Anticipate in 2016 Regulatory Developments Providers: Medicare Payment Reform State Experimentation 42CFR Consumers/Employers Cadillac Tax Employer Mandate Plans Medical Loss Ratio Growing Medicaid enrollment
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25 Traditional Thinking New Thinking
26 Leadership Fearless but not reckless in the Face of Change
27 The care a patient experiences as a result of a team of PC & BH clinicians, working together with patients and families, using a systematic and cost-effective approach to provide patient-centered care for a defined population.* Lexicon for Behavioral Health and Primary Care Integration, AHRQ
28 Practice Change
29 A Population Health Approach Need to think differently about health: move from a focus on providing services to a single individual to measurably improving outcomes for the populations in our communities Key strategies/elements: Prevention Care management Partnerships with primary care providers and others in the healthcare system Data collection & continuous quality improvement Clinical accountability
30 Lathan Medical Group Times Union Blog
31 Six Reasons Behavioral Health Should be Part of Primary Care Reason 1: Prevalence of BH Problems in Primary Care Reason 2: Unmet Behavioral Health Needs in Primary Care Reason 3: Cost of Unmet Behavioral Health Needs Reason 4: Lower Cost When Behavioral Health Needs are Met Reason 5: Better Health Outcomes Reason 6: Improved Satisfaction
32 Fit Kids: Integrated Primary and Mental Health Care Helps Discover Mental Issues Early On
33 Specialty Behavioral Health State Hospital Accept and Adapt 33 Specialized Community Services Integrated Care
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35 35 Specialty Care Specialty organization delivering whole-health care to population with complex psychiatric and addiction conditions (collaborating, co-locating or opening ambulatory health) www. TheNational Council.org Inside medical homes/hospital systems/acos: addressing prevention & early intervention, behaviors & disorders
36 Asian Counseling and Referral Service SAMHSA PBHCI Grantee
37 Deliver World Class Customer Service Streamlining Access Patients and families Health care Public Safety Policy makers Media
38 Implement Measurement Based Care If you don t measure it, you can t improve it If we don t measure it we can t manage it we can t improve it we won t be paid for it!
39 Read to Assume Risk? www. TheNational Council.org Hospitals as Health Systems/insurance companies Insurance Co. as providers Rethinking size and scope of specialty BHOs Geography is not Destiny Colleagues do Compete
40 Prepare The Workforce Training and use of brief, focused assessments and interventions Facilitating client self-care management Credentialing Concurrent Documentation / Technology Smoke-Free Campuses Training and comfort working in diverse treatment settings
41 Adopt Technology Communication Preferences www. TheNational Council.org Coordinate Care Transparency & Benchmarking Replace & Extend Staff
42 Talk a different language with unfamiliar colleagues What can I help you with? Harvard Business Review: Crosscultural Communication 42
43 DO Partnerships Principles DON T Ask about their needs first Give something Assist wherever you can Make it about the next 10 Pursue common interest Reveal anything helpful Take one for the team Talk about your need first Expect to get something Limit assistance to a project Make it about this deal Push a specific position Withhold information Let them take their lumps
44 Communicating Success Improved Outcomes Lower Cost Quality & Consumer Experience
45 Resonate?
46 Health & Recovery
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