TREATING THE WHOLE PERSON WHILE REDUCING COSTS:

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• TREATING THE WHOLE PERSON WHILE REDUCING COSTS

• Practical Lessons from the California Integrated
  Behavioral Health Project

• Mary Rainwater, L.C.S.W.
• Project Director
• Altarum Institute Policy Roundtable
• July 21, 2010

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• OUTLINE

• v Brief Overview of Our Initiative
• v Key Findings
• v The Business Case Quality and Cost
  Improvements
• v The Challenges in Moving from Business Case
  to Policy and Financing Reforms

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• IN SUPPORT OF THE FIELD IBHP BACKGROUND AND
  GOALS

• Launched in 2006 by the Tides Center and The
  California Endowment to accelerate the
  integration of behavioral health services at
  primary care community clinics throughout
  California

• Goals
• Improve behavioral health treatment access
• Reduce stigma of seeking mental health
  services
• Improve patient outcomes
• Strengthen collaboration between mental
  health and primary care providers

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• BUILDING AND SUPPORTING CONNECTIONS ACROSS THE
  FIELD

• Grants
• Build and Support a Learning Community
• Policy and Advocacy Work
• Training and Technical Assistance
• Partnerships and Collaborations

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• LESSONS LEARNED

• Clinical
• v Higher Quality
• v Improved Access
• Operational
• v Requires Customization
• v Not One-Size-Fits-All
• Financial
• v Lower Health Care Costs

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• 1115 MEDICAID WAIVER BEHAVIORAL HEALTH GROUPS
  MENU

• Five Core Elements
• Care Management
• Data Management and Information Exchange
• Consumer Engagement
• Clear Designation of Person-Centered Health
  Care Home
• Performance Measures

• Five Domains to Track Best Practices
• Clinical
• Operational/Administrative
• Financial
• Oversight
• Population-Specific Considerations

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• INTEGRATED CARES BOTTOM LINE

• Lower Overall Health Costs

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• 6-STEP INTEGRATION GAME PLAN

• v Design Clinical Model
• v Identify and Address Funding Barriers
• v Craft Integration Budget
• v Revise Business Processes and Obtain
  Necessary Approvals
• v Design Implementation Plan
• v Monitor and Adjust

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• IDENTIFY ADDRESS FUNDING BARRIERS

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• ALIGNMENT OF CURRENT FUNDING

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• HEALTH CARE REFORM

• Three Components of Health Care Reform
• v Universal Coverage
• v Delivery System Redesign
• v Payment Reform

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• THE BIG FIX

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• CALIFORNIAS PUZZLE

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• HEALTH CARE REFORM AND PARITY CHANGES
  EVERYTHING...

• How services are organized
• How mental illness/substance abuse are addressed
• How mental health/substance abuse treatment are
  funded

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• THANK YOU

• Please visit www.ibhp.org for more information,
  tools and trainings.
• Contact Information
• Mary Rainwater www.mary_at_ibhp.org
• References
• The Business Case for Integrated Care Mental
  Health, Substance Use and Primary Care Services,
  June 2010 Barb Mauer and Dale Jarvis, MCPP
  Healthcare Consulting
• Paying for Integrated Services FQHC, Medi-Cal
  and Other Funding Strategies, June 24, 2010
  Dale Jarvis, CPA, MCPP Healthcare Consulting