[PC-BH-Integration] Outcome measures: Colocation of primary care ina behavioral health care home

BARBARA COHEN BARBARA.COHEN at hhinc.org
Thu Jun 3 13:03:25 EDT 2010


Dana,
Thanks very much for the information. In terms of our own experience
thus far, we benefitted significantly from the recent guidance published
by the  Council  on Affiliation Agreements between FQHCs and Behavioral
Health Organizations when developing our legal agreement.   

Similar to your experience, our challenges to date have been around
funding the initial financial outlays (capital costs and operating
costs) for start-up, as well as space constraints. Costs connected with
the installation of an electronic health record system at a satellite
primary care clinic are significant as are the costs associated with
renovations to create exam rooms with running water, etc. In addition,
we have been advised to plan for longer than usual appointment times for
our consumers, reducing the volume of people seen in the first six
months and projected revenue. We have also been advised to anticipate
the need to "courtesy" some initial visits due to possible delays in the
process when people change primary care providers.

Barbara
>>> dfrantz at adultandchild.org 06/02/10 10:55 AM >>>
Barbara,
Our CMHC has provided a BHC at a local FQHC  for 6 years and we are
now
planning to locate a PHP from the FQHC at our main office to make it
easier and more comfortable for our most seriously mentally ill
consumers to initiate and maintain primary healthcare services.

We have been using the PHQ-9 with people we see at the FQHC as it has
a
cut-off that makes it clear to the providers when to refer and a norm
for significant improvement (50% reduction in the score). It is public
domain, i.e., free for use in primary care settings. We are discussing
other measurement tools, including the Cornell Services Index which
measures healthcare usage including inpt., ED, and rehab services.
This
is attractive as payers will be interested in data on reduced costs.
We
are piloting this with an older adult population as part of a SAMHSA
grant to expand older adult services. We have pursued evidence based
practices including the IMPACT Model.

The challenges included coming up with a business agreement that both
parties felt comfortable with, willingness of both parties to see some
financial outlay as an investment that will pay off eventually,
working
out the proper ways to bill, and getting the MCOs to pay when the regs
indicate that they should. 

There has been a strong commitment on the part of both organizations
to
continue to integrate further. Both of us want to see better
integrated
care for people entering services via either organization and we both
believe this is and should be the future for Primary care and
Behavioral
Health.

I would be glad to talk with you by phone also if you would like.

Dana

Dana Frantz, LCSW
Assoc. Director, Adult Services
Adult and Child Center, Inc.
317-893-0270

-----Original Message-----
From: pc-bh-integration-bounces at lists101.his.com 
[mailto:pc-bh-integration-bounces at lists101.his.com] On Behalf Of
BARBARA
COHEN
Sent: Tuesday, June 01, 2010 4:32 PM
To: pc-bh-integration at lists101.his.com 
Subject: [PC-BH-Integration] Outcome measures: Colocation of primary
care ina behavioral health care home

We are pursuing a pilot that will involve the co-location of an FQHC
satellite primary care clinic in a behavioral health organization that
serves individuals with serious mental illnesses. The goal of this
pilot
is to provide integrated, highly accessible, preventive, primary, and
behavioral health care to individuals with serious mental illnesses
who
receive services in the public behavioral health system.

Is anyone involved in a similar type of partnership? If so, what were
the greatest challenges you experienced in the first year of
operations?
What kinds of outcome measures did you establish for this co-located
care model?

Thank you,
Barbara A. Cohen MSW LSW
Director of Special Projects
Behavioral Health Services
Horizon House
120 South 30th Street
Philadelphia, PA 19104
215/386.3838 Ext. 383
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attached hereto is intended only for the named recipient(s). It is the
property of the ADULT&child Center. and shall not be used, disclosed or
reproduced without the express written consent of ADULT&child Center. If
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