1 / 27

Nevada Behavioral Health Utilization

Nevada Behavioral Health Utilization. FY2010 Update. Presenter Title/Department Date. Agenda. Children’s Services Utilization Snapshot Inpatient Services Residential Treatment Outpatient Services Psychotropic Drugs Adult Services Recommendations. Children’s Services. FY2006– FY2010.

sari
Download Presentation

Nevada Behavioral Health Utilization

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. Nevada Behavioral Health Utilization FY2010 Update Presenter Title/Department Date

  2. Agenda • Children’s Services • Utilization Snapshot • Inpatient Services • Residential Treatment • Outpatient Services • Psychotropic Drugs • Adult Services • Recommendations

  3. Children’s Services FY2006– FY2010

  4. Children’s Utilization Snapshot

  5. Improvements in Children’s Utilization

  6. Inpatient Services– Cost

  7. Inpatient Services – Admissions and LOS

  8. Inpatient Services: Clark vs. Washoe

  9. IP Readmissions and Ambulatory Follow-Up

  10. Residential Treatment– Cost • * Admissions that are still in progress (no record of discharge has been received by fiscal agent as of report run date) are not included. Therefore, admission-based metrics for most recent time period might be underreported for RTC facilities. Those facilities had very long LOS and thus it takes substantially longer for admissions to be included in the data.

  11. Residential Treatment – Admissions and LOS

  12. Outpatient Services Snapshot

  13. Outpatient Services– Penetration Rate

  14. Outpatient Services – Rehab vs. Therapy • * Daily rate billing for Treatment Homes was discontinued in FY2009.

  15. Hour-Based Services

  16. Hour-Based Services: Regional Differences Children from Washoe County have $9,000 higher cost per year compared to Clark County!

  17. Pediatric Pharmacy Concerns Update

  18. Pharmaceutical Utilization • In the last year there was little change in the overall percentage of children using psychotropic drugs. The exceptions are younger Welfare children. The metric went down from 8% to 6% for 0-5 year olds and for down from 33% to 30% for 6-12 year olds. • Utilization of psychotropic drugs is still 3 times higher for children in state custody than in the rest of the Medicaid pediatric population. *Psychotropic drugs are defined as anti-psychotics, anti-depressants, stimulants (for ADHD), or barbiturates/anticonvulsants *Each ‘fill’ represents a purchased prescription of the drug *The ‘Welfare’ aid group are children in state custody

  19. Pharmaceuticals and Lack of BH Services • *BH services included in the analysis are any visit during the year to: • PT 14 Outpatient-Rehab, • PT 26 Psychologist, • PT 20 Physician w specialty 146 Psychiatry and 147 Child Psychiatry, • PT 24 Nurse Practitioner with following procedure codes ('90801', '90802', '90804', '90805', '90806', '90807', '90817', '90819', '90845', '90846', '90847', '90853', '90862' ).

  20. Adult Services FY2006– FY2010

  21. Adult Utilization Snapshot

  22. Adult Outpatient Services: Rehab vs. Therapy

  23. Adult Hour-Based Services

  24. Recommendations

  25. Recommendations for Children’s Services Continue to focus on reducing utilization of inpatient, particularly length of stay in Clark County Continue to focus on reducing utilization of residential treatment; although LOS has decrease significantly over the last few years, there is still room for improvement While Washoe County has done a good job of reducing use of inpatient care and increasing use of community-based services, the increase is beyond what would be expected and requests for these services should be reviewed for appropriateness and length of service The penetration rate for use of outpatient services (15%) is typical for the Medicaid population, however, the number of children receiving psychosocial rehabilitation and skills training is higher than expected; requests for service should be reviewed for progress in treatment and possible duplication of services

  26. Recommendations for Adult Services As with children, the penetration rate for use of outpatient services (14.4%) is typical for the Medicaid population, however, the number of adults receiving psychosocial rehabilitation and skills training is higher than expected; requests for service should be reviewed for progress in treatment and possible duplication of services The majority of adults utilizing outpatient services are receiving therapy; the PUPM is low ($50) which begs the question of the type of service being received. If the majority of adults are receiving medication management, the PUPM would indicate approximately one visit every three months which would be typical. However, if the majority of adults are receiving individual therapy, the PUPM would indicate one visit every month which is low.

  27. Questions and Discussion

More Related