Co lla b o ra tio n a nd I nte g ra tio n o f Psyc hia try L a rry Ho o k, MD Me dic a l Dire c to r, Co lla b o ra tive Ca re Cha ir, De pa rtme nt o f Psyc hia try Ce ntra Ca re
Disc lo sure With re spe c t to the fo llo wing pre se nta tio n, the re ha s b e e n no re le va nt (dire c t o r indire c t) fina nc ia l re la tio nship b e twe e n myse lf o r my spo use a nd a ny fo r-pro fit c o mpa ny whic h c o uld b e c o nside re d a c o nflic t o f inte re st.
Ob je c tive s Pro vide c o nte xt fo r impo rta nc e o f ne w mo de ls � o f c o lla b o ra tio n to suppo rt prima ry c a re pro vide rs a nd pa tie nts Outline le ve ls o f inte g ra tio n o f me nta l he a lth � into the prima ry c a re se tting I de ntify a nd pro vide e xa mple s o f mo de ls o f � inte g ra te d c a re into the prima ry c a re se tting
So me numb e rs… 35% Of c hildre n >60% re c e iving MH c a re o nly sa w o f 66% PCP’ s psyc hia trists we re o lde r o f PCP’ s tha n 55 in re po rt ina b ility 2015 to c o nne c t pts to OP MH >50% 25% o f rura l c o untie s 46% o f pa tie nts ha ve 0 re fe rre d to psyc hia trists o f a d ults will MH b y PCP’ s e xpe rie nc e no sho w MH o r SUD in the ir life time 20% 15k o f prima ry Sho rta g e o f psyc hia trists c a re visits pre dic te d b y 2025 a re MH re la te d Gra phic a rt fro m www.pre se nta tio ng o .c o m
http:/ / www.pa ininthe na tio n.o rg /
Curre nt sta te � Patie nts pre se nt to primary c are o r e me rg e nc y ro o m fo r psyc hiatric c are � Manag e me nt larg e ly o c c urs with primary c are pro vide rs. Whe n additio nal assistanc e re q uire d, re fe rral is made to psyc hiatry and patie nts wait mo nths fo r an intake time , and that assume s psyc hiatric c are is availab le � Primary c are pro vide rs and e me rg e nc y ro o ms are le ft to manag e the patie nts during this time
I nte g ra te d Ca re “T he c are that re sults fro m a prac tic e te am o f primary c are and b e havio ral he alth c linic ians, wo rking to g e the r with patie nts and familie s, using a syste matic and c o st-e ffe c tive appro ac h to pro vide patie nt-c e nte re d c are fo r a de fine d po pulatio n. T his c are may addre ss me ntal he alth and sub stanc e ab use c o nditio ns, he alth b e havio rs (inc luding the ir c o ntrib utio n to c hro nic me dic al illne sse s), life stre sso rs and c rise s, stre ss-re late d physic al sympto ms, and ine ffe c tive patte rns o f he alth c are utilizatio n .” L e xic o n fo r Be ha vio ra l He a lth a nd Prima ry Ca re I nte g ra tio n AHRQ I nte g ra tio n Ac a de my https:/ / inte g ra tio na c a de my.a hrq .g o v/
I nte g ra te d Ca re “T he c are that re sults fro m a prac tic e te am o f primary c are and b e havio ral he alth c linic ians, wo rking to g e the r with patie nts and familie s, using a syste matic and c o st-e ffe c tive appro ac h to pro vide patie nt-c e nte r e fo r a de fine d e d c ar po pulatio n . T his c are may addre ss me ntal he alth and sub stanc e ab use c o nditio ns, he alth b e havio rs (inc luding the ir c o ntrib utio n to c hro nic me dic al illne sse s), life stre sso rs and c rise s, stre ss-re late d physic al sympto ms, and ine ffe c tive patte rns o f he alth c are utilizatio n .” L e xic o n fo r Be ha vio ra l He a lth a nd Prima ry Ca re I nte g ra tio n AHRQ I nte g ra tio n Ac a de my https:/ / inte g ra tio na c a de my.a hrq .g o v/
L e ve ls o f I nte g ra tio n Milb ank Me mo rial F und 2010 Re po rt
L e ve ls o f I nte g ra tio n Milb ank Me mo rial F und 2010 Re po rt
L e ve ls o f I nte g ra tio n Milb ank Me mo rial F und 2010 Re po rt
L e ve ls o f I nte g ra tio n Milb ank Me mo rial F und 2010 Re po rt
Gra phic pro vide d b y www.pre se nta tio ng o .c o m
Co lla b o ra tive Ca re https:/ / a ims.uw.e d u/ nysc c / tra ining / site s/ d e fa ult/ file s/ MCOs%20We b ina r%20Aug %201%202018.pd f
Co lla b o ra tive Ca re Ame ric a n Psyc hia tric Asso c ia tio n https:/ / www.psyc hia try.o rg / psyc hia trists/ pra c tic e / pro fe s sio na l-inte re sts/ inte g ra te d - c a re / le a rn
Be ha vio rist � I n Minne so ta , this is fre q ue ntly re fe rre d to a s I nte g ra te d Be ha vio ra l He a lth � Simila r to Co lla b o ra tive Ca re mo de l with simila r c o re princ iple s � Mo st fre q ue ntly I BH pro vide rs a re psyc ho the ra pists � F re q ue ntly, psyc hia trists a re a lso a va ila b le to pro vide c o nsulta tio n to prima ry c a re pro vide rs � Use s “wa rm ha nd-o ff” � An a rg ume nt c a n b e ma de this mo de l fo c use s mo re o n the to ta lity o f the pa tie nt, whe re e q ua l e mpha sis is pla c e d o n b e ha vio ra l stra te g ie s to a id physic a l he a lth in a dditio n to pro viding suppo rt fo r me nta l he a lth c o nditio ns
Co nsulting Psyc hia try � I n this mo de l, prima ry c a re pro vide rs a c c e ss psyc hia try c o nsulta nts who will pro vide g uida nc e fo r the ma na g e me nt o f the pa tie nt � T he prima ry c a re pro vide r ma y o r ma y no t re vie w the c a se with the psyc hia tric c o nsulta nt prio r to the pa tie nt b e ing se e n � T he psyc hia tric pro vide r ma y se e the pa tie nt fo r a sing le visit, a nd in so me c a se s will fo llo w fo r a c o uple o f visits, b e fo re re turning the pa tie nt to the c a re o f the PCP
T e le mo da litie s � Ca n re a lly b e inc o rpo ra te d into a ny o f the o the r de sig ns � Sync hro no us vs a sync hro no us � Re imb urse me nt issue s re ma in
Psyc hia tric Assista nc e L ine � F re e se rvic e to he a lth pro fe ssio na ls M-F 8AM-6PM 855- 431-6468 � I mme dia te ly c o nne c te d to a L ic e nse d Clinic a l So c ia l Wo rke r who c a n a ssist with tria g e a nd re fe rra ls � Ca n a lso c o nne c t he a lthc a re pro fe ssio na ls to a Bo a rd Ce rtifie d Child a nd Ado le sc e nt Psyc hia trist (usua lly within 30-minute s) to re vie w a c a se o r disc uss a tre a tme nt pla n � F re e se rvic e funde d thro ug h a g ra nt b y DHS
PE RI SCOPE � PE RI na ta l Spe c ia lty COnsult Psyc hia try E xte nsio n 877-296-9049 � F re e re so urc e fo r he a lth c a re pro vide rs c a ring fo r pre g na nt a nd po stpa rtum wo me n who a re strug g ling with me nta l he a lth o r sub sta nc e use diso rde rs � Pro vide r to pro vide r pe rina ta l psyc hia try te le c o nsulta tio n � E duc a tio na l pre se nta tio ns a nd to o ls a va ila b le to pro vide rs o nline � I nfo rma tio n o n a dditio na l c o mmunity re so urc e s in Wisc o nsin tha t suppo rt pe rina ta l me nta l he a lth & we llb e ing � https:/ / the -pe risc o pe -pro je c t.o rg /
Whe re to Go Ne xt--Re so urc e s � AHRQ I nte g ra tio n Ac a de my https:/ / inte g ra tio na c a de my.a hrq .g o v/ � AI MS Ce nte r (Adva nc ing I nte g ra te d Me nta l He a lth So lutio ns) https:/ / a ims.uw.e du/ � APA Co lla b o ra tive Ca re Mo de l http:/ / c o lla b o ra te .psyc hia try.o rg / � Applying the I nte g ra te d Ca re Appro a c h: Skills fo r the PCP (2.0 AMA PRA Cate g o ry 1 Cre dit; F ! ) RE E https:/ / e duc a tio n.psyc hia try.o rg / Use rs/ Pro duc tDe ta ils.a spx? Ac ti vityid=4743&Pro duc tI D=4743&_g a =2.149956658.582895549.15660 89236-1568451715.1564966096
Billing T o o ls: SAMHSA/ HRSA Ce nte r fo r I nte g ra te d He a lth So lutio ns T he me dic a l b illing a nd c o ding c e rtific a tio n ho me pa g e fe a ture s 65 • short, instruc tiona l vide os , whic h c o ve r a wide ra ng e o f b illing a nd c o ding to pic s. T he a b ility to b ill fo r b o th b e ha vio ra l he a lth a nd prima ry c a re se rvic e s • o n the sa me da y is a n e sse ntia l pa rt o f inte g ra ting c a re . T he Ce nte r fo r Me dic a re a nd Me dic a id Se rvic e s (CMS) c re a te d the Billing Prope rly for Be ha viora l He a lth Se rvic e s bookle t to he lp pro vide rs unde rsta nd the la ws a nd re g ula tio ns tha t g o ve rn b illing fo r b e ha vio ra l he a lth se rvic e s. T he re so urc e a lso inc lude s a c he c klist to he lp you e va lua te your billing proc e dure s a nd ide ntify pote ntia l e rrors a nd a re sourc e g uide for your billing sta ff to re vie w c urre nt g uide line s, b illing a nd c o ding , c o ve re d se rvic e s a nd c o mplia nc e info rma tio n. E nha nc e a nd stre a mline yo ur b illing pro c e ss thro ug h Improving Your • hird- Pa rty Billing Syste m , a se lf-pa c e d o nline c o urse fro m SAMHSA’ s T BHb usine ss initia tive . https:/ / www.inte g ra tio n.sa mhsa .g o v/ fina nc ing / b illing -to o ls
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