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Medicaid Matters: Depression and other Psychiatric Illnesses. Jorge Cortina, MD DFAPA West Virginia Medicaid Behavioral Health Medical Director for UniCare an Anthem Company. Cost of Chronic Mental Illnesses.
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Medicaid Matters:Depression and other Psychiatric Illnesses Jorge Cortina, MD DFAPA West Virginia Medicaid Behavioral Health Medical Director for UniCare an Anthem Company
Cost of Chronic Mental Illnesses • Chapel. Prevalence and Medical Costs of Chronic Diseases Among Adult Medicaid Beneficiaries (2017) • https://www.hcup-us.ahrq.gov/reports/factsandfigures/2009/pdfs/FF_report_2009.pdf retrieved 8/27/18 • http://www.mentalhealthamerica.net/issues/2017-state-mental-health-america-ranking-states retrieved 8/27/18 • https://www.nami.org/learn-more/mental-health-by-the-numbers retrieved 8/27/18
Mental Health of West Virginians • WV highest rates of Opioid Used Disorder and complications • (NAS, infections and overdose) • 2nd highest rate of depression (nearly 1 in 4) • Most common in middle aged low income • 2nd highest ratesof smoking(25%) • 11th highest rateof mental illnessor substance abuse • http://www.wvdhhr.org/bph/hsc/pubs/brfss/2016/BRFSS2016.pdf retrieved 8/27/18 • http://www.mentalhealthamerica.net/issues/2017-state-mental-health-america-ranking-states retrieved 8/27/19
Interaction between chronic physical and mental conditions and Social Determinants of Health • Physical illness and conditions such as diabetes, heart disease, COPD increase the risk of depression and depression hinders good self care • Those with Psychiatric and Substance Use Disorders • Higher prevalence of medical illnesses such as COPD, heart disease and diabetes • Less likely to get their conditions diagnosed and treated • More likely to be impoverished, malnourished, homeless, exposed to unhealthy environments • Alexandria, VA: Parks, J., et al. Morbidity and Mortality in People with Serious Mental Illness (2006)
Integrated Care for Physical and Behavioral Disorders Levels of integration 1 2 3 • Coordination • (different settings occasionally sharing information and plans) • Colocation • (greater opportunity for coordination and collaboration) • Integration • (merged, collaborative, single record, strong relationships, frequent contact and informal consultation) • https://www.integration.samhsa.gov/about-us/CIHS_Integration_101_FINAL.pdf retrieved 8/27/18
Healthy People 2020Examples of Social Determinants of Health • https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
Successful Disease Management • https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/how-to-design-a-successful-disease-management-program retrieved 8/27/18
Medicaid Initiatives to address SDOH and Promote Integrated Care