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August 2011

Health Homes: eSolutions, August 2011

eSolutions is a monthly e-newsletter bringing you practical solutions and resources on primary and behavioral healthcare integration from across the United States.

Feature Article: Partnering with Health Homes and Accountable Care Organizations

Grantee Profile: Breaking Ground for Integrated Health: The Mental Health Center of Denver

Quick Tips: Becoming a Health Home Partner

CIHS Webinars

Hot Topics


Partnering with Health Homes and Accountable Care Organizations

Chuck Ingoglia, Vice President, Public Policy, National Council for Community Behavioral Healthcare

Accountable care is a rapidly accelerating concept in the evolving U.S. healthcare system, and Health Homes are one important example—especially under the Affordable Care Act, which includes a Health Homes provision authorizing states to build a person-centered system of care that improves services and outcomes for beneficiaries and increases value for state Medicaid programs.

Akin to a “Medical Home,” a “Health Home” is healthcare delivery approach. Despite any misconception, it is not a physical location—it is a provider or a team of professionals that delivers integrated healthcare, including primary care, dental, and behavioral health services. Operating under a “whole person” philosophy, a Health Home not only provides services to address a person’s health conditions, it also offers expanded services that include the long-term community services necessary for a person to achieve and maintain wellness and recovery.

Health Homes are responsible for providing a full range of healthcare services. According to a National Council for Community Behavioral Healthcare report, a Health Home is equipped to care for the whole patient and manage multiple, interrelated, and chronic health problems. Through new payment mechanisms, these Homes will align their clinical and financial incentives to meet the “triple aim” of improved quality, patient health, and reduced costs. However, Health Homes cannot reach this goal without effectively addressing mental health and substance use, and behavioral healthcare providers must establish the relationship they want with these entities, as well as determine what is required to qualify as partners (See ‘Quick Tips’; CIHS webinar).

Health Homes can significantly improve patient satisfaction. In fact, one consumer recently discussed such integrated services: “I like the fact that I can get everything done in one place. Having medical and mental health services together will help to keep all the doctors in the same loop, so I can get the help I need.”

Health Homes will become principal components of the future healthcare system, and CIHS provides technical assistance to behavioral healthcare and primary care organizations interested in participating. Visit www.centerforintegratedhealthsolutions.org or call 202.684.7457.

For more information, visit the Health Homes section of the CIHS website.

CIHS provides training and technical assistance to the Substance Abuse and Mental Health Services Administration’s Primary and Behavioral Health Care Integration grantees. Each issue of eSolutions profiles a grantee’s work.

Profile of a Primary and Behavioral Healthcare Integration Leader

Breaking Ground for Integrated Health: The Mental Health Center of Denver
Under the direction of the Mental Health Center of Denver CEO and CIHS Steering Committee Member Dr. Carl Clark, MHCD officially broke ground on a new Recovery Center. According to MHCD, the expanded integrated care approach afforded by the new Recovery Center will make it possible for individuals to receive fully integrated behavioral and physical healthcare services under the same roof for the first time ever in Denver. In addition to expanding the behavioral health services provided and increasing MHCD’s overall capacity to serve clients (which will increase by 40%), the Recovery Center will provide support services that include wellness and nutrition programs, housing services, and telemedicine connectivity. In short, it will mark the creation of a Health Home—both literally and symbolically—for consumers to access care for all of their physical and mental health needs all in one place. 

For more information, visit www.mhcd.org

Quick Tips: Become a Qualified Health Home Partner

To ensure readiness to participate in Health Homes, CIHS suggests behavioral healthcare providers take the following four action steps:

1.    Prepare to participate in the larger healthcare field.
Identify and build relationships with community partners, especially primary care.

  • Build competency in team-based care and with Health Homes, in particular.
  • Institute a measurement-based approach to care, incorporating standardized clinical assessment tools into routine service delivery.
  • Gather data on the population served to support recognition as a “high-volume” specialty provider.
  • Increase skills and knowledge in population health management, including wellness, prevention, and disease management approaches.

2.    Establish credentials that demonstrate high performance in the triple aim of improved quality, patient health, and reduced costs.

  • Adopt quality tools and train staff in using them to track performance.
  • Assess clients’ experience of care (including patient-centeredness and cultural/linguistic competence) and address gaps.
  • Document behavioral health and general health outcomes (e.g., body mass index) and implement a plan for improving areas of weaknesses.
  • Know and evaluate the cost and value of the care provided, including the actual costs based on patient severity mix.

3.    Ensure information technology readiness.

  • Institute IT systems that support: exchange of data within and outside the organization; data use as a routine part of clinical work; performance review practices; and management of new payment structures (including linking performance to payment).
  • Form local or regional health information exchanges with community partners.

4.    Plan for an extended period of change.

  • Implement a change management plan.
  • Identify key resources and support networks to stay current on new and emerging practices and financing models.
  • Invest in educating board and staff on operational and clinical changes.

For more information or technical assistance, visit www.CenterforIntegratedHealthSolutions.org or call 202.684.7457.

CIHS Webinars

Brief Behavioral Health Interventions in Primary Care
Save the Date: September 14, 2011
Presenters: Parinda Khatri, PhD, director of integrated care, and Ken Mays, MD, director of primary care services, Cherokee Health Systems

Visit www.centerforhealthsolutions.org for updates and registration. 

Check out recordings and presentations of recent CIHS webinars:

Establishing Smoking Cessation Initiatives in Health Centers
Recorded: August 15, 2011
Presenters: Chad Morris, PhD, director, Behavioral Health & Wellness Program, University of
Colorado; Bettie Blackmon, FNPC, family nurse practitioner, Primary Care Providers for a Healthy Felciana, Inc.

Healthcare providers fully comprehend the impact of tobacco use on health. However, expanding scope of services to include smoking cessation can seem burdensome. This webinar outlined the importance of tobacco control strategies in integrated care settings and provided practical strategies for implementation, including evidence-based clinical and administrative solutions. The speakers highlighted how to establish smoking cessation initiatives utilizing your existing workforce within regular day-to-day operations. The webinar also highlighted how tobacco prevention and cessation services align with quality improvement strategies.
 
Person-Centered Health Homes
Recorded: May 16, 2011
Presenters: Chuck Ingoglia and Larry Fricks, CIHS

This webinar provided an overview of the history and components of the person-centered Health Home model, including whole health and inclusion.

Introduction to Effective Behavioral Health Service Delivery in Primary Care Settings
Recorded: June 1, 2011
Hosted by: National Association for Community Health Centers, a CIHS subcontractor
Presenters: Dr. Alexander Blount, Dr. Miguel Olmedo

Looking for clarification on the differences between co-located behavioral health services and truly integrated care? This webinar provided an introduction for clinicians in Community Health Centers and Community Behavioral Health Organizations interested in evidence-based practices for integrating behavioral health into primary care.

Visit www.CenterforIntegratedHealthSolutions.org for archived recordings and presentations from past webinars.

Hot Topics: News & Resources

National Wellness Week:  September 19-25
The first National Wellness Week will be held as part of SAMHSA’s Recovery Month from September 19–25, 2011. The inaugural theme is “Living Wellness.”

People with mental health and substance use disorders may die decades earlier than the general population, mostly because of preventable medical conditions. SAMHSA—in partnership with the Food and Drug Administration’s Office of Women’s Health—has created the 10x10 Wellness Campaign to promote wellness and increase life expectancies for people with mental health and substance use problems by 10 years, in 10 years.

Visit www.10x10.samhsa.gov for more information.

New Report on Tobacco Use and Mental Illness
On July 21, Legacy, a non-profit that studies tobacco use, released “A Hidden Epidemic: Tobacco Use and Mental Illness.” The report spotlights the high prevalence of tobacco use and nicotine dependence among people with mental illnesses and the barriers to effective cessation efforts to help these individuals quit. The report also features five distinct projects that demonstrate how different organizations address tobacco-related disparities faced by people with mental illnesses.

Illinois Governor Signs Essential CBHC Provider Designation Legislation into Law
On July 22, Illinois Governor Pat Quinn signed into law legislation requiring that the Department Human Services strive to ensure individuals with behavioral health problems have access to local behavioral health care providers who can provide treatment in a cost-effective, outcome-based manner. The law designates essential community behavioral healthcare organizations that meet qualifications that include the promotion of the co-location of primary care and behavioral healthcare services centers. For details, click here

AHRQ Announces Catalogue of Federal Medical Home Activities
The Agency for Healthcare Research and Quality has announced a Catalogue of Federal Patient-Centered Medical Home Activities. The website contains AHRQ’s definition of these homes, white papers on care coordination and the medical neighborhood, and a searchable database of articles. For details, visit AHRQ’s Patient-Centered Medical Home website.

New Commonwealth Fund Report on Clinical Integration
The Commonwealth Fund’s new report, “Assessing and Addressing Legal Barriers to the Clinical Integration of Community Health Centers and Other Community Providers,” outlines the laws and policies governing collaborations between health centers and their partners, and profiles health centers that have worked within the legal framework to develop partnerships that benefit patients, while adhering to the core mission to assure health care for all patients. To access the report, click here

New Fact Sheet on Behavioral Health Coverage of Tobacco Cessation
The Tobacco Control Legal Consortium has issued a new fact sheet on how the Mental Health Parity and Addiction Equity Act and the Affordable Care Act affect insurance coverage for substance abuse benefits related to tobacco cessation.

NIMH Suicide Prevention Research Panel Symposium—September 7
As part of Suicide Prevention Awareness, NIMH is sponsoring a videocast panel of suicide prevention experts, allowing participants to speak directly with those working in the field. The symposium will be held via videocast on September 7, 2011 from 2:00-3:30pm EDT. Click here to register.

National Council Learning Collaborative Supports Integration
The July 2001 issue of Psychiatric Services included the findings from an observational study of the National Council for Community Behavioral Healthcare’s learning collaborative on the integration of services between community health centers and community behavioral health centers. The findings support the learning collaborative as a viable quality improvement approach for enhancing integration of general medical and behavioral health services between CHCs and CBHCs. All teams increased capacity on one or more patient health indicators. For details, access the abstract on the Psychiatric Services website.


To receive this newsletter and other CIHS e-mail updates, click here to enter your e-mail address and select “News from the SAMHSA-HRSA Center for Integrated Health Solutions” from the options listed.

Our free technical assistance services can help primary and behavioral healthcare providers find integrated health solutions that work. To contact CIHS, visit www.centerforintegratedhealthsolutions.org, e-mail Integration@thenationalcouncil.org, or call 202.684.7457.

SAMHSA–HRSA Center for Integrated Health Solutions
Director: Kathy Reynolds; Deputy Directors: Laura Galbreath and Larry Fricks; Editor, eSolutions: Heather Cobb

The SAMHSA–HRSA Center for Integrated Health Solutions, operated by the National Council for Community Behavioral Healthcare under a cooperative agreement from the U.S. Department of Health and Human Services, is funded jointly by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration. The CIHS promotes the development of integrated primary and behavioral healthcare services to better address the needs of people with mental health and substance use conditions, whether seen in specialty behavioral health or primary care settings.


Call Our Helpline: 202.684.7457

Health Homes: eSolutions, August 2011

eSolutions is a monthly e-newsletter bringing you practical solutions and resources on primary and behavioral healthcare integration from across the United States.

Feature Article: Partnering with Health Homes and Accountable Care Organizations

Grantee Profile: Breaking Ground for Integrated Health: The Mental Health Center of Denver

Quick Tips: Becoming a Health Home Partner

CIHS Webinars

Hot Topics


Partnering with Health Homes and Accountable Care Organizations

Chuck Ingoglia, Vice President, Public Policy, National Council for Community Behavioral Healthcare

Accountable care is a rapidly accelerating concept in the evolving U.S. healthcare system, and Health Homes are one important example—especially under the Affordable Care Act, which includes a Health Homes provision authorizing states to build a person-centered system of care that improves services and outcomes for beneficiaries and increases value for state Medicaid programs.

Akin to a “Medical Home,” a “Health Home” is healthcare delivery approach. Despite any misconception, it is not a physical location—it is a provider or a team of professionals that delivers integrated healthcare, including primary care, dental, and behavioral health services. Operating under a “whole person” philosophy, a Health Home not only provides services to address a person’s health conditions, it also offers expanded services that include the long-term community services necessary for a person to achieve and maintain wellness and recovery.

Health Homes are responsible for providing a full range of healthcare services. According to a National Council for Community Behavioral Healthcare report, a Health Home is equipped to care for the whole patient and manage multiple, interrelated, and chronic health problems. Through new payment mechanisms, these Homes will align their clinical and financial incentives to meet the “triple aim” of improved quality, patient health, and reduced costs. However, Health Homes cannot reach this goal without effectively addressing mental health and substance use, and behavioral healthcare providers must establish the relationship they want with these entities, as well as determine what is required to qualify as partners (See ‘Quick Tips’; CIHS webinar).

Health Homes can significantly improve patient satisfaction. In fact, one consumer recently discussed such integrated services: “I like the fact that I can get everything done in one place. Having medical and mental health services together will help to keep all the doctors in the same loop, so I can get the help I need.”

Health Homes will become principal components of the future healthcare system, and CIHS provides technical assistance to behavioral healthcare and primary care organizations interested in participating. Visit www.centerforintegratedhealthsolutions.org or call 202.684.7457.

For more information, visit the Health Homes section of the CIHS website.

CIHS provides training and technical assistance to the Substance Abuse and Mental Health Services Administration’s Primary and Behavioral Health Care Integration grantees. Each issue of eSolutions profiles a grantee’s work.

Profile of a Primary and Behavioral Healthcare Integration Leader

Breaking Ground for Integrated Health: The Mental Health Center of Denver
Under the direction of the Mental Health Center of Denver CEO and CIHS Steering Committee Member Dr. Carl Clark, MHCD officially broke ground on a new Recovery Center. According to MHCD, the expanded integrated care approach afforded by the new Recovery Center will make it possible for individuals to receive fully integrated behavioral and physical healthcare services under the same roof for the first time ever in Denver. In addition to expanding the behavioral health services provided and increasing MHCD’s overall capacity to serve clients (which will increase by 40%), the Recovery Center will provide support services that include wellness and nutrition programs, housing services, and telemedicine connectivity. In short, it will mark the creation of a Health Home—both literally and symbolically—for consumers to access care for all of their physical and mental health needs all in one place. 

For more information, visit www.mhcd.org

Quick Tips: Become a Qualified Health Home Partner

To ensure readiness to participate in Health Homes, CIHS suggests behavioral healthcare providers take the following four action steps:

1.    Prepare to participate in the larger healthcare field.
Identify and build relationships with community partners, especially primary care.

  • Build competency in team-based care and with Health Homes, in particular.
  • Institute a measurement-based approach to care, incorporating standardized clinical assessment tools into routine service delivery.
  • Gather data on the population served to support recognition as a “high-volume” specialty provider.
  • Increase skills and knowledge in population health management, including wellness, prevention, and disease management approaches.

2.    Establish credentials that demonstrate high performance in the triple aim of improved quality, patient health, and reduced costs.

  • Adopt quality tools and train staff in using them to track performance.
  • Assess clients’ experience of care (including patient-centeredness and cultural/linguistic competence) and address gaps.
  • Document behavioral health and general health outcomes (e.g., body mass index) and implement a plan for improving areas of weaknesses.
  • Know and evaluate the cost and value of the care provided, including the actual costs based on patient severity mix.

3.    Ensure information technology readiness.

  • Institute IT systems that support: exchange of data within and outside the organization; data use as a routine part of clinical work; performance review practices; and management of new payment structures (including linking performance to payment).
  • Form local or regional health information exchanges with community partners.

4.    Plan for an extended period of change.

  • Implement a change management plan.
  • Identify key resources and support networks to stay current on new and emerging practices and financing models.
  • Invest in educating board and staff on operational and clinical changes.

For more information or technical assistance, visit www.CenterforIntegratedHealthSolutions.org or call 202.684.7457.

CIHS Webinars

Brief Behavioral Health Interventions in Primary Care
Save the Date: September 14, 2011
Presenters: Parinda Khatri, PhD, director of integrated care, and Ken Mays, MD, director of primary care services, Cherokee Health Systems

Visit www.centerforhealthsolutions.org for updates and registration. 

Check out recordings and presentations of recent CIHS webinars:

Establishing Smoking Cessation Initiatives in Health Centers
Recorded: August 15, 2011
Presenters: Chad Morris, PhD, director, Behavioral Health & Wellness Program, University of
Colorado; Bettie Blackmon, FNPC, family nurse practitioner, Primary Care Providers for a Healthy Felciana, Inc.

Healthcare providers fully comprehend the impact of tobacco use on health. However, expanding scope of services to include smoking cessation can seem burdensome. This webinar outlined the importance of tobacco control strategies in integrated care settings and provided practical strategies for implementation, including evidence-based clinical and administrative solutions. The speakers highlighted how to establish smoking cessation initiatives utilizing your existing workforce within regular day-to-day operations. The webinar also highlighted how tobacco prevention and cessation services align with quality improvement strategies.
 
Person-Centered Health Homes
Recorded: May 16, 2011
Presenters: Chuck Ingoglia and Larry Fricks, CIHS

This webinar provided an overview of the history and components of the person-centered Health Home model, including whole health and inclusion.

Introduction to Effective Behavioral Health Service Delivery in Primary Care Settings
Recorded: June 1, 2011
Hosted by: National Association for Community Health Centers, a CIHS subcontractor
Presenters: Dr. Alexander Blount, Dr. Miguel Olmedo

Looking for clarification on the differences between co-located behavioral health services and truly integrated care? This webinar provided an introduction for clinicians in Community Health Centers and Community Behavioral Health Organizations interested in evidence-based practices for integrating behavioral health into primary care.

Visit www.CenterforIntegratedHealthSolutions.org for archived recordings and presentations from past webinars.

Hot Topics: News & Resources

National Wellness Week:  September 19-25
The first National Wellness Week will be held as part of SAMHSA’s Recovery Month from September 19–25, 2011. The inaugural theme is “Living Wellness.”

People with mental health and substance use disorders may die decades earlier than the general population, mostly because of preventable medical conditions. SAMHSA—in partnership with the Food and Drug Administration’s Office of Women’s Health—has created the 10x10 Wellness Campaign to promote wellness and increase life expectancies for people with mental health and substance use problems by 10 years, in 10 years.

Visit www.10x10.samhsa.gov for more information.

New Report on Tobacco Use and Mental Illness
On July 21, Legacy, a non-profit that studies tobacco use, released “A Hidden Epidemic: Tobacco Use and Mental Illness.” The report spotlights the high prevalence of tobacco use and nicotine dependence among people with mental illnesses and the barriers to effective cessation efforts to help these individuals quit. The report also features five distinct projects that demonstrate how different organizations address tobacco-related disparities faced by people with mental illnesses.

Illinois Governor Signs Essential CBHC Provider Designation Legislation into Law
On July 22, Illinois Governor Pat Quinn signed into law legislation requiring that the Department Human Services strive to ensure individuals with behavioral health problems have access to local behavioral health care providers who can provide treatment in a cost-effective, outcome-based manner. The law designates essential community behavioral healthcare organizations that meet qualifications that include the promotion of the co-location of primary care and behavioral healthcare services centers. For details, click here

AHRQ Announces Catalogue of Federal Medical Home Activities
The Agency for Healthcare Research and Quality has announced a Catalogue of Federal Patient-Centered Medical Home Activities. The website contains AHRQ’s definition of these homes, white papers on care coordination and the medical neighborhood, and a searchable database of articles. For details, visit AHRQ’s Patient-Centered Medical Home website.

New Commonwealth Fund Report on Clinical Integration
The Commonwealth Fund’s new report, “Assessing and Addressing Legal Barriers to the Clinical Integration of Community Health Centers and Other Community Providers,” outlines the laws and policies governing collaborations between health centers and their partners, and profiles health centers that have worked within the legal framework to develop partnerships that benefit patients, while adhering to the core mission to assure health care for all patients. To access the report, click here

New Fact Sheet on Behavioral Health Coverage of Tobacco Cessation
The Tobacco Control Legal Consortium has issued a new fact sheet on how the Mental Health Parity and Addiction Equity Act and the Affordable Care Act affect insurance coverage for substance abuse benefits related to tobacco cessation.

NIMH Suicide Prevention Research Panel Symposium—September 7
As part of Suicide Prevention Awareness, NIMH is sponsoring a videocast panel of suicide prevention experts, allowing participants to speak directly with those working in the field. The symposium will be held via videocast on September 7, 2011 from 2:00-3:30pm EDT. Click here to register.

National Council Learning Collaborative Supports Integration
The July 2001 issue of Psychiatric Services included the findings from an observational study of the National Council for Community Behavioral Healthcare’s learning collaborative on the integration of services between community health centers and community behavioral health centers. The findings support the learning collaborative as a viable quality improvement approach for enhancing integration of general medical and behavioral health services between CHCs and CBHCs. All teams increased capacity on one or more patient health indicators. For details, access the abstract on the Psychiatric Services website.


To receive this newsletter and other CIHS e-mail updates, click here to enter your e-mail address and select “News from the SAMHSA-HRSA Center for Integrated Health Solutions” from the options listed.

Our free technical assistance services can help primary and behavioral healthcare providers find integrated health solutions that work. To contact CIHS, visit www.centerforintegratedhealthsolutions.org, e-mail Integration@thenationalcouncil.org, or call 202.684.7457.

SAMHSA–HRSA Center for Integrated Health Solutions
Director: Kathy Reynolds; Deputy Directors: Laura Galbreath and Larry Fricks; Editor, eSolutions: Heather Cobb

The SAMHSA–HRSA Center for Integrated Health Solutions, operated by the National Council for Community Behavioral Healthcare under a cooperative agreement from the U.S. Department of Health and Human Services, is funded jointly by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration. The CIHS promotes the development of integrated primary and behavioral healthcare services to better address the needs of people with mental health and substance use conditions, whether seen in specialty behavioral health or primary care settings.


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Washington, D.C. 20005

Email: integration@thenationalcouncil.org

Phone: 202-684-7457