1 / 14

Missouri Health Homes

Missouri Health Homes. Integrating Behavioral Health and Primary Care. Paving the Way for Health Homes Missouri’s Health Homes. Missouri is the first state to amend its Medicaid state plan to implement Health H omes. Statewide 36,000 enrolled

chaela
Download Presentation

Missouri Health Homes

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. MissouriHealth Homes Integrating Behavioral Health and Primary Care

  2. Paving the Way for Health HomesMissouri’s Health Homes • Missouri is the first state to amend its Medicaid state plan to implement Health Homes. • Statewide • 36,000 enrolled • Missouri will have three types of Health Homes • Primary Care Chronic Conditions Health Home • Federally Qualified Health Centers (FQHCs) • Rural Health Centers (RHCs) • Physician practices • Community Mental Health Center Health Home • Multi-Payer Person Centered Medical Homes

  3. Paving the Way for Healthcare HomesWhy CMHC Healthcare Homes? • Because addressing behavioral health needs requires addressing other healthcare issues • Individuals with SMI, on average, die 25 years earlier than the general population. • 60% of premature deaths in persons with schizophrenia are due to medical conditions such as cardiovascular, pulmonary and infectious diseases. • Second generation anti-psychotic medications are highly associated with weight gain, diabetes, dyslipidemia (abnormal cholesterol) and metabolic syndrome.

  4. Maine Study Results: Comparison of Health Disorders Between SMI & Non-SMI Groups

  5. Principles • Physical healthcare is a core service for persons with SMI • MH systems have a primary responsibility to ensure: • Access to preventive healthcare • Management and integration of medical care

  6. Healthcare HomesExpectations: We can meet them Cost Savings Analysis of CMHC Clients Enrolled in CCIP

  7. CMHC Savings Off Trend

  8. Total HealthCare Utilization Per User Per MonthPre and Post Community Mental Health Case Management Average Medicaid expenditures per month Months with case management initiated on month 24

  9. CMHC Outcomes comparing admission to annual assessments • Independent Living increased by 33% • Vocational Activity increased by 44% • Legal Involvement decreased by 68% • Psychiatric Hospitalization decreased by 52% • Illegal Substance use decreased by 52% • IN ADDITION- Study shows CMHCs services substantially decrease overall medical cost

  10. Out Reach Target Population • $25,000 minimum cost for previous 12 months or risk predicted to have high cost • A diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or recurrent major depression • Not a consumer of public mental health system in previous 12 months • Excluded nursing home, developmental disability, hospice and renal failure • Average cost of group over$50,000 per year Analysis of Care Management

  11. Physical Health Demographic 35%COPD 34% Asthma 32% Diabetes 11% Congestive Heart Failure (CHF) Analysis of Care Management

  12. Cost Savings Including Cost of Intervention • 1298 clients enrolled for over 6 months • $346 PMPM actual cost savings • $5.4 Million annualized • $619 PMPM trended cost savings • $9.6 Million annualized DM 3700 Progress

  13. Opportunities for Federal Policy Improvement • Push for Deeper Implementation of Parity • Assure that Essential and Benchmark Benefit includes rehabilitation benefit parity • Allow Safety Net BH Providers access to 340B pharmaceutical pricing • Prohibit States from not paying for a PC visit and a BH visit on the same day • Include BH providers in Federal HIT funding

  14. Paving the Way for Health HomesQuestions? Website: www.dmh.mo.gov Click on Healthcare Home link

More Related