The Chicago Forum for Justice in Health Policy: Learning and Advocacy for Behavioral Health – Primary Care Integration Monday, June 25, 2018 Loyola University Regents Hall
About us Founded in 1981 by Dr. Quentin Young, Health & Medicine was formed as an action-oriented policy center — nimble, independent, and focused on regional health issues . We conduct research, educate, and collaborate with other groups to advocate policies and impact health systems to improve the health status of all people. Health & Medicine has successfully developed health policy recommendations and implementation strategies for different public and private entities, earning the trust of the legislature, advocates, the media, researchers, and policymakers at all levels of government in Illinois to become the region’s “honest broker” on healthcare policy matters.
Health & Medicine Programs • Center for Long-term Care • Chicago Area Schweitzer Fellows Program • Chicago Area Health Education Center (AHEC) • Court Involved Youth • Free Standing Birth Centers • Center for Public Health Equity • Illinois ACEs Response Collaborative Learn more at www.hmprg.org
BH-PC Integration Learning Collaborative • Launched in 2015 with funding by BCBS of Illinois, and staff from Clayton Residential Home, Community Behavioral Healthcare Association of Illinois, Enterprise Health Care Management, Erie Family Health Center, Grand Prairie Services, Heartland Alliance Health, Heartland Health Centers, Lutheran Social Services of Illinois, Sinai Health System, Thresholds, Trilogy, and Turning Point. • The purpose is to develop strategies to better implement evidence-based models for integration of BH and PC that will facilitate more effective utilization of available resources and expand the capacity of BH and PC providers to provide high quality, person-centered care to more people in need.
Forum Objectives • Explore the conceptual framework and lessons learned of Health & Medicine’s Behavioral Health -Primary Care Integration Learning Collaborative established from the three years of shared learning. http://www.hmprg.org/Programs/Behavioral+Health+Primary+Care+I ntegration • Highlight three topic areas – data exchange; hospital transitional care; and financial sustainability – to understand what local collaboration can learn regarding best practices and current challenges to integrated care. • Explore lessons being learned in other collaboratives working on similar BH-PC integration efforts. • Identify policy reform opportunities to improve statewide behavioral health-primary care integration, and create recommendations for local and state-wide advocacy.
Agenda Welcome/Forum Overview 9:00am Learnings from Year Three: Releasing the Playbook Hospital Transitions Workgroup Financial Sustainability Workgroup Data Exchange Workgroup Integrating the Integrators: Respondent Panels & Audience Q/A Exploring new opportunities in Illinois: Kelly Cunningham, IHFS Sharing feedback on lessons learned from payors: Raman Eremia, Enterprise Health Care Management; Felix Rodriguez, CountyCare, Samantha Olds Frey, IAMHP Identifying policy recs to meet ongoing challenges to data exchange: Sana Syal and Laura Merrick/MHNConnect; Michael Frierro Randazzo, Envolve Health; Peter Eckart, IPHI Moving into the Future: Sharing Among other Learning Collaborati ves Safety Net Learning Collaborative; CountyCare/C4 BH-PC Integration Learning Collaborative; CDPH MAT Learning Collaborative; Alliance for Health Equity; CDPH Healthy People 2.0 BH Integration Workgroup; IAMHP BH Committee. Adjourn 12:30pm
Hospital Transitional Care Workgroup • John Seller & Raman Eremia, Health Care Services Corp & Enterprise Health Care Management of BCBSIL • Jessica Lyke & Arnie Kanter, Clayton Residential Home • Joan Liautaud & Kelly Jones, Heartland Alliance Health • Matt Hammoudeh & Tim Sheehan, Lutheran Social Services of Illinois • Eric Lenzo & Mirna Ballestas, Sinai Health System • Ron Otto, Thresholds
Financial Sustainability Workgroup • Gwenn Raush & Molly Bougearel, Heartland Health Centers • Sheila O’Neill & Debbie Pavik, Thresholds • Samantha Handley & Corinne Foster, Trilogy • Ann Fisher Raney & Lowell Raven, Turning Point
Data Exchange Workgroup • Marvin Lindsey & Terry Carmichael, Community Behavioral Healthcare Association of Illinois • Raman Eremia, Enterprise Health Care Management of BCBSIL • Mary Talen & Robin Varnado, Erie Family Health Center • Cheryl Andrews, Grand Prairie Services
Data Exchange • Data exchange and health information technology was identified as one of the six key integration criteria, yet we also recognized the importance of this for all of the other five integration criteria. • Health care silos are not only physical and technological, but also operational and cultural. • Few metrics and incentives have been created to address BH-PC integration, yet validated metrics of quality outcomes specifically for integrated care are central to achieving the triple aim of increase patient satisfaction, improved health, and lower costs.
Data Exchange Study • Mapping our own integration practices to the six criteria. • Seeking outside experts on data exchange, including health home programs in Missouri and Washington State. • Attempted a data exchange feasibility study for a small- scale platform to share information across settings. • Unable to implement without an active health home program in Illinois. • Lack of specific integration metrics among our members. For example, FQHCs are only required to report depression screening to HRSA.
Data Exchange Findings • Shifted focus to support the work of the Hospital Transitional Workgroup and the Financial Sustainability Workgroup, who were each facing challenges with technology and data-sharing, as well as ambiguity on how to identify relevant outcome measures. • Surveyed members on EHR systems used by BH and PC providers, and whether their disparate systems can share data. • Key finding: BH and PC providers use HIT in very different clinical contexts and do not share a common lexicon to discuss process improvement for mutual goals.
Integrating the Integrators: Respondent Panels and Audience Q & A Exploring new opportunities for advancing integration with policy changes at the state level. • Kelly Cunningham, Deputy Administrator for Long-Term Care, IL Dept of Healthcare & Family Services.
BH Transformation Documents https://www.illinois.gov/hfs/SiteCollectionDocuments/MEDWACMay23.pdf https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By- Topics/Waivers/1115/downloads/il/il-behave-health-transform-ca.pdf https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By- Topics/Waivers/1115/downloads/il/il-behave-health-transform-fs.pdf
Integrating the Integrators: Respondent Panels and Audience Q & A Sharing feedback on lessons learned from managed care payors. • Raman Eremia, Manager BH Quality Improvement & Data Analysis, Enterprise Health Care Management/BCBSIL; • Felix Rodriguez, Manager of BH Services, CountyCare; • Samantha Olds Frey, Executive Director, IL Association of Medicaid Health Plans.
Integrating the Integrators: Respondent Panels and Audience Q & A Identifying policy advocacy recommendations to meet ongoing challenges to data exchange. • Sana Syal, Project Manager, MHNConnect; • Michael Frierro Randazzo, Senior Director, Envolve Health; • Peter Eckart, Director, Center for Health and IT, Illinois Public Health Institute.
Moving Into the Future: Sharing Among other Learning Collaboratives • Safety Net Learning Collaborative • CountyCare/C4 BH-PC Integration Learning Collaborative • CDPH MAT Learning Collaborative • Alliance for Health Equity • CDPH Healthy People 2.0 BH Integration Workgroup • IAMHP BH Committee.
Learning Collaboratives facilitated by McAlpine Consulting for Growth, LLC Health & Medicine Policy Research Group BH-PC Integration LC, 2015 – present 6 BH agencies, 2 PC agencies, 2 agencies with both BH and PC certified programs, 1 BH trade association, 1 MCO (BCBS) Safety Net Learning Collaborative, 2011 – present 16 PC centers (mostly FQHCs) + 1 specialty center (IL Eye Institute) CountyCare/C4 BH-PC Integration LC, 2016 – present 21 PC centers, 12 BH centers, 3 care management entities, 1 MCO (CountyCare) Of the 33 centers, 3 have both BH and PC certified programs, and 1 with both is a hospital . Chicago Department of Public Health Medication Assisted Treatment (MAT), 2017 – present 10 FQHCs, 1 agency with both BH and PC certified programs, 2 hospitals
Learning Collaborative Work Accomplished/Tools Safety Net HMPRG CDPH MAT CountyCare/C4 • • • • Learning Set of articles Completing Completed 1 st year of 1 st year of Events, 6 at times/yr www.hmprg.o decision- Learning since 2014 rg maker Events, 6 • • Leadership In process quarterly sessions. • Institute, 2 with two trainings Set focus for cohorts, feasibility and study in annual since studies: provider 2018: 2015 financial quarterly Strengthenin • Position sustainability; trainings g the specific hospital Continuum Discussion transitions of Care in and Metro Networking Chicago. Groups, annual since 2016
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