The Un-coordinated Costs of Behavioral and Primary Health Care: An Analysis of State Studies
Provides detailed case studies of state programs (CA, MO, MI, NY, WA, and OH) aimed at greater coordination of behavioral and primary health care. The studies consistently show clients who have behavioral disorders have higher medical costs under uncoordinated care and some studies also demonstrate the ability of coordinated behavioral and primary health care to lower state costs.
This report was developed by the National Association of State Mental Health Program Directors (NAHMSPD) in September 15, 2015.
Comparative effectiveness of collaborative chronic care models for mental health conditions across primary, specialty, and behavioral health care settings: systematic review and meta-analysis.
The authors conducted a systematic review and meta-analysis of randomized controlled trials to determine the comparative effectiveness of chronic care models (CCMs) for mental health conditions across disorders and treatment settings. Authors conclude that CCMs can improve mental and physical outcomes for individuals with mental disorders across a wide variety of care settings and that they provide a robust clinical and policy framework for care integration.
Published in the American Journal of Psychiatry in August 2012. Authors: Woltmann E, Grogan-Kaylor A, Perron B, Georges H, Kilbourne AM, and Bauer MS.
Mental Health and Substance-Use Reforms — Milestones Reached, Challenges Ahead
Legislation regarding mental health parity and other health policy reforms have improved access to treatment for mental health and substance-use disorders, but ongoing problems include a shortage of mental health specialists and lack of system-wide integration.
Published by the New England Journal of Medicine on August 18, 2016. Authors: Haiden A. Huskamp, Ph.D., and John K. Iglehart
Association of Integrated Team-Based Care With Health Care Quality, Utilization, and Cost.
Study evaluated the association of receiving primary care in integrated team-based care (TBC) practices vs. traditional practice management (TPM) practices (usual care) with patient outcomes, health care utilization, and costs. Among adults enrolled in an integrated health care system, receipt of primary care at TBC practices compared with TPM practices was associated with higher rates of some measures of quality of care, lower rates for some measures of acute care utilization, and lower actual payments received by the delivery system.
Published by the Journal of the American Medical Association (JAMA) on August 23, 2016. Authors: Brenda Reiss-Brennan, PhD, APRN; Kimberly D. Brunisholz, PhD; Carter Dredge, MHA; Pascal Briot, MBA; Kyle Grazier, PhD; Adam Wilcox, PhD; Lucy Savitz, PhD; Brent James, MD, MStat.
Emergency Department Length-Of-Stay For Psychiatric Visits Was Significantly Longer Than For Nonpsychiatric Visits, 2002–11
Using a retrospective analysis of national emergency department (ED) visit data in the period 2002–11, authors found that psychiatric patients who visited the ED experienced a significantly longer length of stay than non-psychiatric patients and were transferred to another facility at six times the rate of non-psychiatric patients. These findings suggest deficiencies in ED capacity for psychiatric care, which may necessitate improvements in both emergency department processes and alternative models of care.
Published in the Health Affairs in September 2016. Authors: Jane M. Zhu, Astha Singhal, and Renee Y. Hsia.
Effects of a Medical Home and Shared Savings Intervention on Quality and Utilization of Care.
During a 3-year period, a medical home intervention in the northeast region of the Pennsylvania Chronic Care Initiative, which included shared savings for participating practices, was associated with relative improvements in quality, increased primary care utilization, and lower use of emergency department, hospital, and specialty care. With further experimentation and evaluation such interventions may continue to become more effective.
Published by the Journal of the American Medical Association Internal Medicine in August 2015. Authors: Friedberg MW, Rosenthal MB, Werner RM, Volpp KG, and Schneider EC.
Transitioning Between Systems of Care: Missed Opportunities for Engaging Adults with Serious Mental Illness and Criminal Justice Involvement
This study examines how such individuals involved in the criminal justice system describe their experiences receiving care both during and after their time in custody, and explores the perspectives of mental health service providers who treat this population upon re-entry. Findings identify specific target areas for improved care coordination as well as for additional provider education regarding the unique needs of this population.
Published in Behavioral Health Sciences and the Law in August 2013 Authors: Pope LG, Smith TE, Wisdom JP, Easter A, and Pollock M.
How Effective Are Different Welfare-to-Work Approaches?
This report reviews 11 different welfare-to-work program approaches for effectiveness and longterm impact on income. The report breaks down differences between employment-focused and education-focused programs, as well as specific findings for children, among the 11 different programs.
Published by MDRC in December 2001. Authors: Hamilton, G., Freedman, S., Gennetian, L., Walter, J., Adams-Ciardullo, D., Gassman-Pines, A., McGroder, S., Zaslow, M., Ahluwalia, S., Brooks, J.
Mental Health Parity and Addiction Equity Act: A Watershed Moment for the Future of Behavioral Health Care
This white paper drafted by the Colorado Coalition for Parity looks at the Mental Health Parity and Addiction Equity Act and the ACA in the context of mental health and substance use treatment. The paper overviews prohibited practices often used by managed behavioral health care organizations and proposes alternatives.
Published by The Colorado Coalition for Parity in January 2014.
A Payer-Guided Approach to Widespread Diffusion of Behavioral Health Homes in Real-World Settings
This research study follows an innovative behavioral health home for three years that implemented two distinct treatment approaches, patient-driven and provider-driven, to improve client outcomes. The results showed increased patient activation in care, increased engagement with primary care, and better perceived mental health status.
Published by Health Affairs in February 2018. Authors: Schuster, J., Nikolajski, C., Kogan, J., Kang, C., Schake, P., Carney, T., Morton, S., & Reynolds, C.
Potential economic impact of integrated medical-behavioral healthcare: Updated projections for 2017
This report, updated for 2017, reviews healthcare costs and utilization data to project spending estimates for individuals living with chronic medical and comorbid behavioral health conditions. Treatment costs for patients with comorbid medical and mental health/substance use disorder are on average two to three times higher than costs for chronic medical conditions alone.
Published by Milliman in January 2018. Authors: Melek, S., Norris, D., Paulus, J., Matthews, K., Weaver, A. & Davenport, S.
The Behavioral Health Workforce Needed for Integration with Primary Care: Information for Health Workforce Planning
This descriptive study provides information that can be used by policymakers, practitioners, educators and other health workforce planning stakeholders to develop plans and policies to increase access to behavioral health care services through primary care settings. Developing the behavioral health workforce needed for integration requires ongoing resources (including data and analysis, planning, policies, and funding) with support needed at the national, state and community levels. This study provides a framework to inform the process of planning and developing the behavioral health workforce that can meet these integration needs.
Published by the University of Washington’s Center for Health Workforce Studies in April 2016. Authors: Skillman, S., Snyder, C., Frogner, B. & Patterson, D.
Parity Resource Guide for Addiction & Mental Health Consumers, Providers and Advocates
This resource guide and toolkit is meant to support mental health and substance use providers to help them better understand the rights and benefits under parity law and how to file appeals from insurance companies for coverage denials.
Published by the Parity Implementation Coalition and the Kennedy Forum in Winter 2015. Editors: Carneal, G., McDiad, C., Middlebrook, B. & Strain, H.
Integration of behavioral health and primary care: current knowledge and future directions
This paper summarizes current scientific knowledge about integrated primary care and critically evaluates the strengths and weaknesses of this knowledge base, focusing on clinical, financial and operational factors. Recommended priorities for future research, dissemination, real-world implementation, and health policy implications are presented.
Published by Journal of Behavioral Medicine in February 2017. Authors: Vogel, M., Kanzler, K., Aikens, J. & Goodie, J.