Download or read book Primary Care and Mental Health Integration in Coordinated Care Organizations written by and published by . This book was released on 2017 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt: The prevalence of untreated and undertreated mental health concerns and the comorbidity of chronic conditions and mental illness has led to greater calls for the integration of primary care and mental health. In 2012, the Oregon Health Authority authorized 16 Coordinated Care Organizations (CCO) to partner with their local communities to better coordinate physical, behavioral, and dental health care for Medicaid recipients. One part of this larger effort to increase coordination is the integration of primary care and mental health services in both primary care and community mental health settings. The underlying assumption of CCOs is that organizations have the capacity to fundamentally change how health care is organized, delivered, and financed in ways that lead to improved access, quality of care, and health outcomes. Using the Rainbow Model of Integrated Care (RMIC), this study examined the factors that impact organizational efforts to facilitate the integration of primary care and mental health through interviews with executive and senior staff from three CCOs. The RMIC focuses attention on the different levels at which integration processes may occur as well as acknowledges the role that both functional and normative enablers of integration can play in facilitating integration processes within as well as across levels. The following research question was explored: What key factors in Oregon's health care system impede or facilitate the ability of Coordinated Care Organizations to encourage the integration of primary care and mental health? Using a case study approach, this study drew upon qualitative methods to examine and identify the factors throughout the system, organizational, professional, and clinic levels that support CCO efforts to facilitate the integration of primary care and mental health. Fourteen primary interviews were conducted with executive and senior staff. In addition, eleven secondary interviews from a NIDA funded project as well as twenty-four key CCO documents from three CCOs were also included in this study. The RMIC was successful in differentiating extent of CCO integration of primary care and mental health. Findings demonstrate that normative and functional enablers of integration were most prevalent at the system and organization level for integrating mental health into primary care for these three CCOs. However, there was variation in CCO involvement in the development of functional and normative enablers of integration at the professional and clinic levels. Normative and functional enablers of integration were limited at all of the RMIC levels for integrating primary care into community mental health settings across all three CCOs. The Patient-Centered Primary Care Home model provided CCOs with an opportunity to develop functional and normative enablers of integration for integrating mental health in primary care settings. The lack of a fully developed model for integrating primary care services in community mental health settings serves as a barrier for reverse integration. An additional barrier is the instability of community mental health as compared to primary care; contributing factors include historically low wages and increased administrative burden. System wide conversations about where people are best served (i.e., primary care or community mental health) has yet to occur; yet these conversations may be critical for facilitating cross-collaboration and referral processes. Finally, work is needed to create and validate measures of integration for both primary care and community mental health settings. Overall findings confirm that integrating primary care and mental health is complex but that organizations can play an important role by ensuring the development of normative and functional enablers of integration at all levels of the system.
Download or read book Improving the Quality of Health Care for Mental and Substance Use Conditions written by Institute of Medicine and published by National Academies Press. This book was released on 2006-03-29 with total page 528 pages. Available in PDF, EPUB and Kindle. Book excerpt: Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.
Download or read book Coordinating Care Between Behavioral Health and Primary Care Providers written by Nicole Kristin Janich and published by . This book was released on 2017 with total page 155 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health care in the United States has been undergoing significant changes since the 2010 passage of the Patient Protection and Affordable Care Act. One of the outcomes of this policy was an attempt to bring physical health care and behavioral health care together in an effort to provide more coordinated care for patients. This change created an opportunity to improve the quality of care for patients, and as a result reduce high cost emergency service that could be prevented through better maintenance of chronic conditions. Three studies were conducted to examine challenges behavioral health agencies face in implementing two models of coordinated care (co-located and fully integrated), staff and organization capacity and needs, and patient service utilization by model of care coordination. The first study used site visits and interviews to capture the challenges faced by agencies. Results from this study indicated that behavioral health agencies faced a number of challenges in providing coordinated care including financial barriers, regulations, information sharing, inadequate technology, and provider training needs. The second study used a staff survey to assess agency and staff capacity and needs in providing coordinated care. The results from this study found differences in capacity based on model of coordination in multiple dimensions related to inter-agency coordination and communication, role clarity, and team cohesion. The third study examined patient service utilization for outpatient visits, inpatient visits, and emergency visits. The results indicated that patients receiving care from co-located agencies were more likely to have at least one encounter in each of the three service utilization categories compared to patients at fully integrated agencies. Overall, the three studies suggest that agencies that have or will implement models of coordinated care face significant barriers that may impact the sustainability or feasibility of such care. Given the findings on patient service utilization, it seems that coordinated care has great potential for patient level outcomes which makes addressing agency barriers even more critical.
Download or read book Integrated Behavioral Health in Primary Care written by Stephanie B. Gold and published by Springer. This book was released on 2018-11-01 with total page 249 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides an evidence-based guide for primary care physicians seeking to integrate behavioral health into their practice. This is grounded in the underlying notion that integrating behavioral health and primary care is not an adjustment to practice but a reconstruction of how primary health care is defined and delivered. While some aspects (billing and financing) will be specific to the policy context in the United States, much of the book will contain universal lessons for an approach to integration from a primary care perspective that may be relevant across the globe. This guide is organized to follow a comprehensive approach, derived from lessons learned by early adopters of integration. Dividing the book in this manner creates a unique and natural flow from the “why” of integrating care to a step-by-step approach to achieve integration in a practice. The book includes the case for why integrating behavioral health is important; what integration looks like in practice; and how to transform a practice and grow a team of clinicians to work together to address mental, emotional, and behavioral problems. Each chapter starts with a short preamble to introduce the stage of integration. Each chapter and subchapter would end with a summary box of key messages and a short list of resources (articles, websites, etc) for further information for each topic. Where relevant, chapters additionally include a brief section on application for specific populations (pediatrics, geriatrics, etc). This is an ideal guide for primary care physicians and their medical and administrative teams interested in integrating behavioral health in their practice.
Download or read book Closing the Quality Gap written by Kaveh G. Shojania and published by . This book was released on 2004 with total page 7 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-07-19 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Download or read book Caring for People with Mental Health and Substance Use Disorders in Primary Care Settings written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2021-01-30 with total page 123 pages. Available in PDF, EPUB and Kindle. Book excerpt: Behavioral health conditions, which include mental health and substance use disorders, affect approximately 20 percent of Americans. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. As many as 80 percent of patients with behavioral health conditions seek treatment in emergency rooms and primary care clinics, and between 60 and 70 percent of them are discharged without receiving behavioral health care services. More than two-thirds of primary care providers report that they are unable to connect patients with behavioral health providers because of a shortage of mental health providers and health insurance barriers. Part of the explanation for the lack of access to care lies in a historical legacy of discrimination and stigma that makes people reluctant to seek help and also led to segregated and inhumane services for those facing mental health and substance use disorders. In an effort to understanding the challenges and opportunities of providing essential components of care for people with mental health and substance use disorders in primary care settings, the National Academies of Sciences, Engineering, and Medicine's Forum on Mental Health and Substance Use Disorders convened three webinars held on June 3, July 29, and August 26, 2020. The webinars addressed efforts to define essential components of care for people with mental health and substance use disorders in the primary care setting for depression, alcohol use disorders, and opioid use disorders; opportunities to build the health care workforce and delivery models that incorporate those essential components of care; and financial incentives and payment structures to support the implementation of those care models, including value-based payment strategies and practice-level incentives. This publication summarizes the presentations and discussion of the webinars.
Download or read book Integrated Behavioral Health in Primary Care written by Mary R. Talen and published by Springer Science & Business Media. This book was released on 2013-06-04 with total page 369 pages. Available in PDF, EPUB and Kindle. Book excerpt: Contributed by experts who’ve developed integrative healthcare initiatives with strengths in the areas of policy and principles, organizational systems, or clinical practice. These contributors will illustrate the concepts and describe the nuts and bolts of their integration initiatives. In the conclusion of each section, the editors will construct a template to systematically evaluate these essential elements. This template will organize the information to help stakeholders compare and contrast the strengths, resources, limitations and challenges of how each model meets the vision of integrative healthcare. In the concluding section the information in the preceding sections connects to provide a coherent synopsis of the common themes and practices, from the macro to micro levels of care, which foster successful integration of the medical and psychosocial systems.
Download or read book Primary Care written by Institute of Medicine and published by National Academies Press. This book was released on 1996-09-05 with total page 411 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.
Download or read book Integrating Behavioral Health and Primary Care written by Robert E. Feinstein and published by Oxford University Press. This book was released on 2017 with total page 593 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. These models of care are patient-centered. population focused, and delivered by a multidisciplinary team of medical professionals. This book is practical, office-based, comfortably accessible, and intended for mental health professionals, primary care and medical specialists, and professional health students, residents, and other professionals working in integrated care environments.
Download or read book Managing Managed Care written by Institute of Medicine and published by National Academies Press. This book was released on 1997-04-21 with total page 394 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations. Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues. The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened. Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral healthâ€"federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.
Download or read book Integrated Care written by Lori E. Raney, M.D. and published by American Psychiatric Pub. This book was released on 2017 with total page 292 pages. Available in PDF, EPUB and Kindle. Book excerpt: Real-life examples provided by clinical staff who made the transition to collaborative care are woven into the text, providing insight into the goals of improving outcomes, patient satisfaction, and cost containment.
Download or read book Social Work and Integrated Health Care written by Victoria Stanhope and published by Oxford University Press. This book was released on 2018 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a comprehensive view of the critical issues for social workers regarding the integration of primary care and behavioral health care. It discusses integrated health care settings, interprofessional practice, new roles for social workers, and describes key evidence-based practices such as screening, person-centered care planning, motivational interviewing and wellness self-management.
Download or read book Integrated Care in Psychiatry written by Paul Summergrad and published by Springer Science & Business. This book was released on 2014-04-26 with total page 245 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrated Care in Psychiatry: Redefining the Role of Mental Health Professionals in the Medical Setting is a landmark title in the field, offering a clear, detailed, and cohesive call by leading experts for coordinated care for patients with concurrent psychiatric and medical conditions. The renowned editors and authors argue that what is slowly occurring, and greatly needed at a faster pace, is nothing less than a sea change in the way that psychiatric care will be delivered. The current, mostly segregated, medical and psychiatric model of care has led to the development of competing medical and psychiatric subcultures that have resulted in a lack of dialog among health providers, administrators, and payers – and thus in less than optimal patient outcomes. To remedy this problem, the book offers a practical, insightful road map to achieving the central tenet of health reform – truly coordinated, patient-centered care where the care experience for the patient, the medical care itself, and the cost outcomes improve as the system changes from fee-for-service to population-based health. An invaluable reference for all clinicians, policy makers, payers, administrators, and others interested in the debate surrounding healthcare systems, Integrated Care in Psychiatry: Redefining the Role of Mental Health Professionals in the Medical Setting is a major contribution to the literature and a gold standard resource.
Download or read book Integrating Mental Health Into Primary Care written by World Health Organization and published by World Health Organization. This book was released on 2008 with total page 224 pages. Available in PDF, EPUB and Kindle. Book excerpt: Presents the justification and advantages of providing mental health services in primary care. Provides advice on how to implement and scale-up primary care for mental health, and describes how a range of health systems have successfully undertaken this transformation. Part 1 provides the context for understanding primary care for mental health within the broader health care system. Part 2 explains how to successfully integrate mental health into primary care and highlights 10 common principles which are central to this effort. It also presents 12 detailed case examples to illustrate how a range of health systems have undertaken this transformation. Annex 1 provides information about the skills and competencies that are required to effectively assess, diagnose, treat, support and refer people with mental disorders.
Download or read book Implementing High Quality Primary Care written by National Academies of Sciences, Engineering, and Medicine and published by . This book was released on 2021-06-30 with total page 448 pages. Available in PDF, EPUB and Kindle. Book excerpt: High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.
Download or read book Integrated Care written by Lori E. Raney and published by American Psychiatric Pub. This book was released on 2015-04-01 with total page 302 pages. Available in PDF, EPUB and Kindle. Book excerpt: The goals of Integrated Care: Working at the Interface of Primary Care and Behavioral Health are to educate psychiatrists about the fundamental shift underway in health care and to prepare them to be successful and effective in the new health care arena. The passage and implementation of the Patient Protection and Affordable Care Act presents an opportunity for newly insured patients and for funding models of integrated care, enabling psychiatrists to have a more significant population-level impact. The only book of its kind, the guide defines integrated care, reviews the evidence base, and addresses the three potential benefits of this model of care: improved outcomes, cost containment, and enhanced patient experience (also known as the "triple aim"). The new models of integrated care presented in this book are population-based, which is the key to improved outcomes, and they represent a change in how medicine in general and psychiatry in particular will approach health care delivery moving forward. The book's features are both high-impact and user-friendly: The book is divided into two sections, "Behavioral Health in Primary Care Settings" and "Primary Care in Behavioral Health Care Settings," with Section 1 focused on improving the detection and treatment of behavioral health conditions by integrating behavioral health services into primary care settings and Section 2 focused on improving the health status of patient populations with serious mental illness by integrating primary care into behavioral health treatment. Each chapter presents a set of "core principles of effective collaborative care," which serve as a guide for the structure and provision of care for the varying models, regardless of the setting. Contributors provide dozens of examples that highlight the impact psychiatrists can make in achieving the triple aim of improved outcomes, cost containment, and enhanced experience. Detailed case vignettes integrated throughout the book bring concepts to life and help clinicians to understand and improve the patient-provider relationship. The information presented in these chapters allows both practicing psychiatrists and those in training to develop a skill set essential to designing, working in, teaching, or promoting an integrated care program within a health care system. Evidence based and timely, Integrated Care: Working at the Interface of Primary Care and Behavioral Health is a must read for clinicians in the brave new world of health care reform.
