Ann Marie Sullivan, MD Commissioner NY State OMH
} BET ETTER ER HEA EATLH OF THE E POPULATION: Prevention and Maximizing Wellness } BET ETTER ER CARE E FOR EA EACH PATIEN ENT: Quality Care focused on patient choice, engagement, and satisfaction; clinical best practices; integrated care between medical and psychiatric services; coordinated care with Primary care Medical Home; Increase in insured patients requires increased access to care } LOWER ER COST: Performance based payment; More efficient and effective care focused on decreasing preventable admissions and readmissions; and more comprehensive integrated ambulatory care (PCMH)
} Partnerships between mental health providers and aging services providers offer opportunities for screening and treatment of the whole individual, mind and body.
} Collaborative Care for late life depression } 15% of elderly in Primary Care have a treatable depression } Randomized Trial: 8 health centers and 18 clinics } Primary Care patients 60 and older with major depression or dysthymia } Treatment: Pharmacologic and Care Management } Outcomes: } >50% drop in SCL-20 depression scores at 6months and 12 months
5 Source: ¡United ¡Hospital ¡Fund, ¡New ¡York ¡Beneficiaries ¡with ¡Mental ¡Health ¡and ¡Substance ¡Use ¡Condi?ons, ¡2011 ¡
Patients without MH/SA diagnosis, medical readmission $149M Patients with MH/ SA diagnosis , medical readmission $395M Patients with MH/ SA diagnosis, MH/SA readmission $270M 6
} Established a Geriatric Health Planning Council } and } Geriatric Demonstration Projects in Integrated Health care to test various approaches: } Model 1: Physical Health Care in Behavioral Health Settings (19 projects) } Model 2: Behavioral Health in Physical Health settings (12 Projects)
} Medicaid Managed Care and HARPS focus on integrating physical and behavioral health } NY State Collaborative Care Initiative funded 19 academic sites to train primary care residents in integrated depression treatment in primary care } DSRIP : 26 Proposals chose collaborative care as their behavioral health project } Integrated Care needs to be imbedded in FIDA and MLTC plans
} Adequate reimbursement from Medicaid Managed Care, Medicare, and commercial payers for the services: what is the cost? How can the service be maintained when “grant” dollars no longer available? } Providers need to be trained to implement effective, evidence based models. } Regulations and licensing procedures need to reflect changing practice and facilitate integrated care.
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