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Independent Practice and IntegratedCare
PLC Legacy Sponsor
2017 CE Technology
2017 Pre-Conference Wifi
PLC Gold Sponsor
2017 Conference Wifi
Kevin D. Arnold, PhD,...
PLC 2017 Sponsors
• Various Models inVarious States
• Varies by Setting (Hospital, Hospital Owned PCP,
Independent PCP)
• ...
Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Wash...
Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Wash...
Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Wash...
Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Wash...
PLC 2017 Sponsors
• PCP Integrated BH models in Hospital Systems
• Most Systems Owned by Hospitals
• Employees of Hospital...
PLC 2017 Sponsors
• Aggressive Pursuit of Integration
• Approached Large Non-Hospital Based PCP Network (50+
Offices)
• So...
PLC 2017 Sponsors
• Met initially with Director of Adult and of Pediatric
Medicine and the COO
• Met with the Medical Staf...
Central Ohio Primary Care Physicians
• Founded in July 1996 11 Offices/33 Physicians
• 2017 - 320 Physicians in 58 locatio...
COPC Network Coverage
COPC
PLC 2017 Sponsors
• Access to PMPM Payment Models
• Reduced PCPTime during Encounter
• Positioning for Future Private Paye...
PLC 2017 Sponsors
• Did Literature Research on Health Care Costs and Cost
Reductions
• BuiltTriple Aims Capacity (Patient ...
PLC 2017 Sponsors
 “Not surprisingly, depression has been shown to increase medical costs in patients with
these problems...
PLC 2017 Sponsors
• In a Milliman Research Report (Melek and Norris, 2008), the authors
reported that patients with chroni...
PLC 2017 Sponsors
• Metrics
• Not “BDI” outcomes
• Is Health Outcomes
• Prevention Behaviors
• Medical Compliance
• Reduce...
PLC 2017 Sponsors
• Prevention Models and Levels
• IHI andTriple Aims
• SAMSHA/HRSA
• Innovation (Stand Still is Fall Behi...
apapractice.org
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Integrated Behavioral Health Presentation at American Psychological Association Practice Leadership Conference

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These slides are from my presentation at the APA PLC 2017. They address integrated behavioral healthcare, per member-per month payments, and preventive application of behavioral healthcare

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Integrated Behavioral Health Presentation at American Psychological Association Practice Leadership Conference

  1. 1. Independent Practice and IntegratedCare
  2. 2. PLC Legacy Sponsor 2017 CE Technology 2017 Pre-Conference Wifi PLC Gold Sponsor 2017 Conference Wifi Kevin D. Arnold, PhD, ABPP Owner and President Center for Cognitive and BehavioralTherapy & The Assoc. of Practices for Evidenced Based CBT (APEB) Columbus, OH www.ccbtcolumbus.com kda1757@gmail.com Clinical Faculty, Ohio State University Dept. of Psychiatry and Behavioral Health
  3. 3. PLC 2017 Sponsors • Various Models inVarious States • Varies by Setting (Hospital, Hospital Owned PCP, Independent PCP) • SAMSHA/HRSA Definitions http://www.integration.samhsa.gov/integrated- care-models What is Integrated Care?
  4. 4. Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Washington, D.C.SAMHSA- HRSA Center for Integrated Health Solutions. March 2013
  5. 5. Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Washington, D.C.SAMHSA- HRSA Center for Integrated Health Solutions. March 2013
  6. 6. Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Washington, D.C.SAMHSA- HRSA Center for Integrated Health Solutions. March 2013
  7. 7. Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Washington, D.C.SAMHSA- HRSA Center for Integrated Health Solutions. March 2013
  8. 8. PLC 2017 Sponsors • PCP Integrated BH models in Hospital Systems • Most Systems Owned by Hospitals • Employees of Hospital Systems • Early Adoption ofValue-Based Integration • Independent PCP Practices are Often Stand-Alones Using Code Based Fee for Service • Not Much Interest in Integration Re: Cost Experience in Central Ohio
  9. 9. PLC 2017 Sponsors • Aggressive Pursuit of Integration • Approached Large Non-Hospital Based PCP Network (50+ Offices) • Sought Integration • Was Offered Co-Location • Needed to Prove Clinical and BusinessValue • Obtained Better EHR (Valant)—Meaningful Use Certified/Inter- operable to Create Integration Potential for EHR • Value Markers: Patient Experience,Timeliness of Referral Process, Quality of Care, “Free” Integration (Warm Hand-Off Available, On-going MutualValuation (including Patient Messaging) Experience For CCBT
  10. 10. PLC 2017 Sponsors • Met initially with Director of Adult and of Pediatric Medicine and the COO • Met with the Medical Staff at the First Location • Launched about 8 months after Initial Meeting • Payment Currently CPT Code Based • Add Location to FTID to Avoid Problems Later • NegotiateCo-Location Agreement • Set Up Additional Informed Consent Form Central Ohio Primary Care
  11. 11. Central Ohio Primary Care Physicians • Founded in July 1996 11 Offices/33 Physicians • 2017 - 320 Physicians in 58 locations. • FourCounties: Franklin, Delaware, Union, Fairfield • 60% Internal Medicine (70 Dedicated Hospitalists) • 20% Family Practice & 20% Pediatrics • Subspecialties Endocrinology, Rheumatology, ID, PMR • 325,000 + Active Patients in Metro Columbus • 100% Physician Owned and Governed • COPC is 27% of the Central Ohio Primary Care Market
  12. 12. COPC Network Coverage COPC
  13. 13. PLC 2017 Sponsors • Access to PMPM Payment Models • Reduced PCPTime during Encounter • Positioning for Future Private Payer PMPM Models orValue Based Contracting FutureValues
  14. 14. PLC 2017 Sponsors • Did Literature Research on Health Care Costs and Cost Reductions • BuiltTriple Aims Capacity (Patient Experience Measure) • Saw Payers as Partners • PreparedWhite Papers • ApproachedCarriers • Negotiated FirstVBC in 2017 Value Based Contracting
  15. 15. PLC 2017 Sponsors  “Not surprisingly, depression has been shown to increase medical costs in patients with these problems by 50% to 70%, according to recent research published in the Archives of General Psychiatry. In that study, when nurse care managers monitored patients diagnosed with depression and either diabetes or heart disease, the patients had lower mean outpatient costs of $594 per person and 114 more depression-free days compared with patients who received usual care.” (http://medicaleconomics.modernmedicine.com/medical- economics/content/tags/affordable-care-act/integrating-primary-care-and-mental-health- key-im?page=full)  “Primary prevention efforts will be needed to address common risk factors for comorbid conditions, such as adverse health behaviors and substance use, in their social and environmental contexts. Secondary prevention should include screening for common mental disorders in primary care settings and for common medical health conditions in specialty medical settings.” (http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2011/rwjf69438/subasse ts/rwjf69438_1) Basics of Behavioral HealthValue
  16. 16. PLC 2017 Sponsors • In a Milliman Research Report (Melek and Norris, 2008), the authors reported that patients with chronic medical conditions and depression were 2.1 more likely to eat healthy less than 1x per week, and 1.3 times more likely to eat more than 6 high fat foods per week. (Melek, S. & Norris, D. (2008). Chronic Conditions and Comorbid Psychological Disorders. Seattle: Milliman.] • Primary PreventionThrough Early Intervention—Target Highly CoMorbid Medical Dx atTime of Dx • Secondary Prevention—Screenings (e.g., PHQ-9,Vanderbilts) atWellVisits, Referral for Diagnostic Consult andTx Planning for EarlyTreatment, Stabilization, and Sx Reduction/Elimination • Tertiary Prevention—Screenings and Diagnostics with CoMorbid Sx Presentation, Stabilization, Sx Management/Reduction/Elimination • Use of CBT, EBTs that are a)Theoretically Modeled and b) Enjoy Strong Empirical Support Basics of Behavioral HealthValue (the CCBT Way)
  17. 17. PLC 2017 Sponsors • Metrics • Not “BDI” outcomes • Is Health Outcomes • Prevention Behaviors • Medical Compliance • Reduced High-Cost Utilization • Consults to PCPs re Med Management and Compliance • Relates Directly to Reduced Costs of Co-Morbidity • QOL of Patient • Management of Health Care Services for Public Health Improvement Value Based Contracting
  18. 18. PLC 2017 Sponsors • Prevention Models and Levels • IHI andTriple Aims • SAMSHA/HRSA • Innovation (Stand Still is Fall Behind) • Meaningful Use Certified EHR • DefineValue-based Role in Health Care (Redefine Independent Practice as Inter-dependent Practice) Keys to Know
  19. 19. apapractice.org

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