Telehealth Secrets 2019: Integration of Medical and Behavioral Health (IBMH) models - Eric Haden, Drexly

1. Who We Are:
Founded in 2019 we are group of healthcare
executives with careers focused on improving
populations access and quality of care to
vulnerable populations with complex health
needs. Making a difference in healthcare is what
drives us
Populations and Providers, we serve:
Mental Health Population they are on the front lines
for treating the 45.6 Million Americans with mental
illness, with 11.5 million having serious mental
illness (SMI or SPMI)
Substance Abuse Population– America is in a
substantial public health crisis with over 10-15
million Americans suffering from addiction.
Drexly Healthcare Solutions, LLC
Long Term Goal of Drexly - Drexly to be part of the
development Integrated Medical Behavioral Home (IBMH)
models across the U.S.
Why Integrate Medical and Behavioral Health?
Milliman estimates IMBH models can save as much as
$37.6 billion to $67.8 billion annually in the U.S.
PROJECTED HEALTHCARE COST SAVINGS THROUGH
EFFECTIVE INTEGRATION (NATIONAL, 2017) PAYER TYPE
ANNUAL COST IMPACT OF INTEGRATION
COMMERCIAL $19.3 - $38.6 BILLION
MEDICARE $ 6.0 - $12.0 BILLION
MEDICAID $12.3 - $17.2 BILLION
TOTAL $37.6 - $67.8 BILLION
“Milliman Research Report: Potential Economic Impact of Integrated Medical-Behavioral Healthcare, Updated Projections for 2017”, January 2018, Page 1

2. Source: Kaiser Family Foundation Health Tracking Poll: April 2016. Available at: http://kff.org/report-section/kaiser-health-tracking-poll-april-2016-substance-abuse-and-mental-health/
OneinfiveAmericansreporttheyorafamilymember
didnotreceiveneededmentalhealthservices
Don’t know/
Refused
1%
Yes
21%
No
78%
Was there ever a time when you or
another family member in your
household thought you might need
mental health services but did not get
them?
Don’t know/
Refused
Yes No
8%
10%
12%
13%
0% 5% 10% 15%
Didn't know where to
go to get care
Afraid or embarrassed
to seek care
Insurance wouldn't
cover it
Couldn't afford the
cost
Of those who reported not receiving care,
the following percentage reported the
reason for foregoing care as:
Percentage of respondents with the following answers to questions asked in April 2016:

3. Source: Kaiser Family Foundation State Health Facts
Opioid OverdoseDeath as apercentofall Drug OverdoseDeath 1999-2017

4. Mental Health Spending Vs. GDP per capita 2015

5. Spending allocated to psychiatric hospitals Vs. GDP 2015

6. Alternative Payment Models - High Level Examples

7. Integration of Medical and Behavioral Health Continuum
Fee For
Service
(FFS)
P4P/Performance
Based Contracting
Case Rate -
Episodic Based
Bundling
Contact Capitation
(Diagnostic
Specific/population
management
Shared
Savings/Risk
Fully Capitated
Episodic Bundling
Capitation over a specific period
such as based on a specific
disease condition
Accountable Care models
w/without Shared Risk Programs
(i.e. Pharmacy Risk Pools)
Global Capitation
Degree of care provider integration and accountability
LevelofFinancialRisk

8. Examplesof ofIntegratedDeliveryModelsof Care

9. Detox
Inpatient
Resident
Partial Hospital
IOP
/Group Therapy
Individual
Therapy
Peer RecoveryCrisis Services
Social Services
M.D./APN
MFT/LCSW
FQHC/CMHC
Mental Health
Office/Clinic
Primary Care
Social Worker
LCSW/MFT/ABA
Psychiatry
Case Management
Community-based
Services
Urgent Care
Specialist Care
Retail Clinics
Mobile Care
Lifestyle/Wellness
Areas in Red can have augmented and/or provided in wraparound telehealth
network
Substance Abuse Continuum of CareIntegrated Medical Behavioral Health Model (IBMH)

10. Current U.S. Initiatives are at best and Fragmented
Nicholas Timmins: Canterbury, New Zealand’s quest for integrated care September 2013

11. Nicholas Timmins: Canterbury, New Zealand’s quest for integrated care September 2013
Vision of Working IMBH Care Model

12. DRexly Health Solutions, LLC
Eric C. Haden – President
714-675-4897
ehaden@drexly.com
THANK YOU