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FOR ADMINISTRATORS:  MEDICAL COST OFFSET IN INTEGRATED CARE

 

The links below provide the background needed for mental health and health care administrators to develop models and systems for integrating mental health services with medical care. 

1.      “Your Hospital’s Path to the Second Curve:  Integration and Transformation”  
           A Report of the American Hospital Association, January 2014 

The Affordable Care Act is fundamentally changing the way healthcare is delivered and is pressuring healthcare organizations to redefine payment and care delivery. This is requiring a shift from the “1st curve” of operating in a volume-based environment to the “2nd curve” of building value-based care systems and business models. Most healthcare organizations are currently in the transition period between the 1st and 2nd curves, known as “life in the gap.” To survive “life in the gap,” leaders will need to take new and different risks that result in greater clinical, financial, operational and cultural integration which will essentially redesign the delivery of care. 

(Link to summary(Link to full document)

2.      “Integrating Behavioral Health Across the Continuum of Care”
           
A Report of the American Hospital Association, February 2014

Hospital and care system leaders are pursuing a more comprehensive and integrated approach toward delivering health care. Integrating behavioral health across the care continuum helps create a seamless system of care that offers patients the services they need, when they need them, whatever setting they are in… The American Hospital Association report outlines five case examples of different medical systems that have implemented integrated care. Each example describes the health care setting, where integration occurred, the results achieved due to integrated care and the lessons learned using the integrated care model. 

(Link to summary(Link to full document)

3.      “Behavioral Health Challenges in the General Hospital”
           American Hospital Association Behavioral Health Task Force Report, 2007

Several national reports have been written to address the many problems with hospital-based behavioral health services, but none focuses significantly on behavioral health services provided by general, community hospitals.Therefore, the AHA formed a Task Force on Behavioral Health to develop realistic strategies to assist hospital leaders in establishing an appropriate behavioral health role for their general, acute care hospital, and provide real-world examples of hospitals that have successfully addressed the behavioral health care needs of their communities. In this report, the task force provides recommendations to hospital leaders on behavioral health service strategies and examples of successful practices that can serve as models for implementing the recommendations.

(Link to report) 

4.    “TrendWatch”
          
American Hospital Association Research Reports

These American Hospital Association research reports examine key issues to inform the policy making process. These include the TrendWatch series, a periodic AHA publication that reports on the latest trends affecting hospitals and the health care system (now conducted in collaboration with Avalere Health) as well as other AHA sponsored studies. 

  (Link)

5.      “The Medical Home’s Impact on Cost and Quality:  An Annual Update of the Evidence,
            2012-2013”
            Patient-Centered Primary Care Collaborative

            A summary of key points from this year’s report include:

  1. PCMH studies continue to demonstrate impressive improvements across a broad range of categories including: cost, utilization, population health, prevention, access to care, and patient satisfaction, while a gap still exists in reporting impact on clinician satisfaction.
  2. The PCMH continues to play a role in strengthening the larger health care system, specifically Accountable Care Organizations and the emerging medical neighborhood model.
  3. Significant payment reforms are incorporating the PCMH and its key attributes.

(Link to full document)

6.      “Benefits of Implementing the Primary Care Patient Centered Medical Home:  A Review
           of Cost and Quality Results, 2012”
           Patient-Centered Primary Care Collaborative

This report updates the earlier reviews of the cost and quality data from 2009 and 2010, and the findings are clear, consistent, and compelling: Data demonstrates that the PCMH improves health outcomes, enhances the patient and provider experience of care, and reduces expensive, unnecessary hospital and emergency department utilization. The results provide substantial empirical support for the PCMH and the health care professionals, health plans, employers and policymakers who are adopting it, as well as the patients and their families receiving this care.

  (Link to full document)

7.      “The ‘Big Data’ Revolution in Healthcare:  Accelerating Value and Innovation”
            McKinsey & Company

This report will help payors, pharmaceutical companies and providers develop proactive strategies for winning in the new health care environment. It first explains the changes that are making this “big data’s” moment and then describes the new “value pathways” that could shift profit pools and reduce overall cost in the near future. The report concludes with recommended priorities for stakeholders, including providers and payors.

  (Link to full document)

8.      Other resources

Healthcare leaders must stay on top of new technologies, new companies, future trends and the latest policies, with a perspective that includes the entire healthcare ecosystem: Health IT, medical devices, health systems, venture investing, mobile apps, biotech and pharma. MedCityNews is comprehensive and provides context and analysis on daily news updates as well as annual events. They give readers the chance to speak to and learn from everyone who has a stake in improving healthcare. 

  (Link to MedCityNews)

 

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