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Tools for Care-Coordination: How to Build “Improvement Partnerships” with Managed Care, Primary Care and Behavioral Health Organizations
Tuesday, November 18, 2014: 10:30 AM - 12:00 PM
California, like many states, has a complex safety-net healthcare ecosystem of funding streams for medical, mental health, and substance use treatment. In addition to creating separate service delivery systems, the system’s complexity includes multiple regional Medicaid payor and provider systems, managed health and behavioral health plans, Federally Qualified Health Centers, behavioral health agencies, and hospitals. This complexity, combined with a widespread passion for addressing the high-morbidity and early-mortality of persons with serious-mental-illness, has been a catalyst for advancing primary care and behavioral health integration.
This Session explores the efforts of six Learning-Collaboratives to advance integration using tools from the “Model for Improvement” and the “Institute for Healthcare Improvement’s Breakthrough Series.” Over five-years, the California Institute for Behavioral Health Solutions managed Collaboratives involving cross-sector teams representing urban and rural California. Convened originally to transform cross-sector clinical practices, these efforts have been adapted to pilot payment-reform strategies. Because all health-care is local, lessons presented during this session about collaborative strategies used in the geographically and organizationally diverse regions of California will be relevant to other States and localities.
Presentations will offer four approaches that build effective collaborations between managed health and behavioral health plans, behavioral health departments and their providers, public health departments, primary care providers, and hospitals. Each presentation includes measurement outcomes, lessons learned, and practical tips to help administrators, providers, and policy makers advance integration efforts across the country. THE INTEGRATION HIGHWAY describes the key components of improvement that includes coordination at the payor level to support integration at the provider level. BUILDING NEW NEIGHBORHOODS explores how the Institute for Healthcare Improvement’s Breakthrough Series model is being used to support clinical and organizational change. CAN'T WE JUST TALK TOGETHER? ADVANCING CLINICAL INFORMATION SYSTEMS TO SUPPORT WHOLE PERSON HEALTH AND REDUCE STIGMA addresses how clinical information systems are a necessary part of the solution. MANAGED CARE AS A CATALYST TO IMPROVEMENT provides a deeper dive into how health plans can be leaders in supporting primary care and behavioral health integration.
Together these sessions help us understand how local communities working together on well-planned and coordinated initiatives can achieve the Triple Aim.
Session Objectives: Explain the importance of coordination at the payor level to support integration at the provider level.
Describe how learning collaboratives can be an accelerant for effective integration.
Assess the role of clinical information systems in supporting effective care coordination.
See individual abstracts for presenting author's disclosure statement and author's information.
Organized by: Mental Health
Endorsed by: Medical Care Section, Public Health Social Work, Caucus on Homelessness, Community Health Planning and Policy Development
Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)
Masters Certified Health Education Specialist (MCHES)