Outpatient psychiatric clinics
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Outpatient Psychiatric Clinics. To Be or Not To Be. The Fundamental Problem. How do we manage outpatient clinics to meet the needs of people we serve while remaining financially viable?. What we learned. Providers value outpatient services Similar to a “clinical home”

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Outpatient Psychiatric Clinics

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Outpatient psychiatric clinics

Outpatient Psychiatric Clinics

To Be or Not To Be

The fundamental problem

The Fundamental Problem

How do we manage outpatient clinics to meet the needs of people we serve while remaining financially viable?

What we learned

What we learned

  • Providers value outpatient services

  • Similar to a “clinical home”

  • Services are accessible, person-centered, person-directed, evidenced based, continuous, culturally appropriate & coordinated

Challenging trends and developments

Challenging Trends and Developments

  • Community based treatment is increasing

  • As options increase, so does fragmented care

  • Managed care is the largest payer of services

  • Workforce shortage

Challenging trends and developments1

Challenging Trends and Developments

  • Deinstitutionalization of state hospital

  • Recovery, resiliency & evidenced based approaches

  • Integrating primary health, behavioral health & substance abuse treatment

Challenging trends and developments2

Challenging Trends and Developments

  • Focus on treating co-occurring disorders

  • Developing & utilizing performance improvement activities

  • Large demand for BHRS and services in natural environments

Challenging trends and developments3

Challenging Trends and Developments

  • Alternatives to incarceration

  • More uninsured individuals seeking treatment

  • Mental health parity

Impact on services

Impact on Services

  • High “No Show” rates

  • Reimbursement for psychiatrists does not cover costs

  • Psychiatrists have become “Medication Managers”

Impact on services1

Impact on Services

  • Full-time staff replaced by independent contractors

  • Required services that are unbillable

  • Large deficits

Impact on services2

Impact on Services

  • Sources to offset deficits have shrunk

  • Clinics downsizing and closing

What can we do

What can we do?

  • In depth evaluation by the state into the feasibility and viability of outpatient psychiatric clinics

  • Make changes to develop a new system for delivering outpatient services in the public sector

Change regulations

Change Regulations

  • Allow service to be delivered in the community

  • Establish flexible staffing patterns

  • Change the role of the psychiatrist

Change regulations1

Change Regulations

  • Promote flexible treatment planning

  • Move away from annual licensing visits

  • Eliminate time limited waivers

Ensure financial stability

Ensure Financial Stability

  • Increase rates, especially for psychiatric services

  • Reimburse for nonbillable services

  • Support Full-time staff

  • Alternative payment or mixed payment options

Outpatient psychiatric clinics

A new approach is needed to meet the needs of consumers without compromising services.

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