When You've Defined One Integrated Model You've Defined One (OPEN MINDS)

NYAPRS Note: Below is an interesting article about the various models for integration of behavioral and physical health from our friends at OPEN MINDS. Don’t miss out on exploring this topic more deeply at our Executive Seminar to be held on April 25th and 26th in Albany. There will be a special workshop on Integration featuring Peter Campanelli, Founder of ICL and Principal of Strategic Organizational Development, James Schuster, MD, Chief Medical Officer of Community Care Behavioral Health and Elizabeth Swain, President and CEO of Community Health Care Association of NY State (CHCANYS). Presenters will share innovative approaches at integration that are currently underway and discuss barriers and strengths for different models in both upstate/rural and urban areas.

And, don’t miss Monica Oss, the CEO and Senior Associate for OPEN MINDS, present on the keynote panel “Tools for Today and Tomorrow: Inspiration, Innovation, Integration and Adaptation”. Then receive more one on one chance to exchange thoughts with Monica at her workshop on “Finding the Opportunities in Healthcare Reform: The Inside Track”.

You’ll get expert guidance on how to best position your agency from one of the nation’s leading authorities.

In just two days, you’ll hear the latest details about not only innovative integrated health, but also clinic and peer service initiatives in the context of the coming move to fully capitated Medicaid managed care. You’ll get the scoop on how employment, cultural competence and peer support are rising to the forefront of system redesigns.

You don’t have to leave New York: we’ve brought some of the nation’s leading experts to Albany in this very timely, information packed experience... and all in 2 days!

Register today for NYAPRS April 25-6 Annual Executive Seminar at https://registration.nyaprs.org/; see program schedule at https://registration.nyaprs.org/forms/ExecutiveSeminarProgram2013.pdf.

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When You've Defined One Integrated Model, You've Defined One

OPEN MINDSWith all the discussion of integration, a key question is - how is an integrated model defined. This was one of many elements in the session at the 2013 OPEN MINDS Performance Management Institute in February, when OPEN MINDS team members ellise l.g. hayden and Susan L. Markley joined Kathleen Reynolds of National Council for Behavioral Health in exploring integrated models (see Making Money With Integrated Care: Optimizing Your Integration Strategy For Financial Sustainability premium members). Here are the four models providers should be aware of:

Collaboration between separate providers - Providers using this model develop either formal or informal agreements as to how they will operate to provide both physical and behavioral health services. One requirement for this to work is that there's full disclosure of services provided to the client. Within this model, the providers may both use different tracking systems and work with multiple payers for processing claims. A drawback to this model is that it remains more provider-centered as opposed to client-centered.

Co-location - Many integration projects begin with a co-location model, where mental health professionals and primary care providers practice at the same site, building or office. This is beneficial as patients do not need to travel to multiple locations for services. With this type of arrangement, there's typically more information sharing among the providers and an opportunity to provide a warm hand-off for the client. Primary care providers have found that patients who receive referrals to mental health providers are less likely to follow-through with a visit when in a separate facility. One drawback is that co-located practitioners may lack the time, operational support, and motivation to work collaboratively to consult about patient care.

Consultant model - In the consultant model, a mental health professional is a member of the primary care team at the same work site and follows a schedule that can mimic the primary care model, including brief interventions and consultations. This model emulates the Federally Qualified Health Center (FQHC) model and allows the patient access to a behavioral health professional typically on the same day as a physical provider. Sometimes the interactions with the mental health professional can be shorter and may also result in referrals to deal with some of the more complex issues around behavioral health.

Fully integrated - In this model, the client benefits from a one-stop shop for addressing both physical and mental health needs. All providers are within one group which allows the center to manage from one integrated health record and generate one bill for providing services. In this model, effective case care coordination becomes the norm as the primary care physician and behavioral health practitioner work together to create a treatment plan. As patients work through chronic conditions and other physical ailments, they also have greater access to working with someone to deal with any behavioral problems, resulting in a much more structured and monitored effort.

And, for more on integration models from the OPEN MINDS Industry Library, see:

Looking ahead to the challenge of making integrated models produce good outcomes and achieve financial sustainability, definition is key...


Jim Jenkins

Senior Associate, OPEN MINDS