If you have an emergency department you are in the behavioral health business
Download
1 / 24

- PowerPoint PPT Presentation


  • 75 Views
  • Uploaded on

If you have an Emergency Department, you are in the Behavioral Health Business…. August 2012. Retrieved from http://mediagallery.usatoday.com/G373. If you have an ED…. The question is: How do you deal effectively with the need in your community?. 3. Number of people turning 65 each day

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about '' - trang


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.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
If you have an emergency department you are in the behavioral health business
If you have an Emergency Department, you are in theBehavioral Health Business…..

August 2012



If you have an emergency department you are in the behavioral health business

If you have an ED…

  • The question is:

  • How do you deal effectively with the need

  • in your community?

3


If you have an emergency department you are in the behavioral health business

Number of people turning 65 each day

Average Life Expectancy in 2010

Reduction in State and local behavioral health funding from 2009 to 2012

The percentage increase of patients presenting in your ED with behavioral health diagnosis from 2006 - 2009

Average wait for psychiatric patients in ED

If you have an ED…

Some Numbers:

10,000

78.3

$1.6B

20%

8 hours

4


If you have an emergency department you are in the behavioral health business

Adults with comorbid behavioral health and medical conditions

Patients discharged from community hospitals with a behavioral health primary diagnosis in 2009

Percentage of community hospitals with an organized inpatient behavioral health unit

Reduction in hospital based units from 2008-2010

Number of hospitals with emergency departments

If you have an ED…

Some Numbers:

17%

2.0 M+

27

10%

4,850

5


If you have an emergency department you are in the behavioral health business

National Trends: conditions

Increased funding pressure on State and local behavioral health resources

Hospital based behavioral health beds trending down

Increased number of behavioral health emergencies

Increased demand for treatment services for older adults with co-occurring physical conditions and behavioral health needs

Integration of behavioral health and medical treatment

Increased demand for consultation and liaison services

Increased use of multi-disciplinary team approach

Impact of National Health Reform

If you have an ED…

6


If you have an emergency department you are in the behavioral health business

Overall Trend: conditions

Utilization is increasing, capacity decreasing, impacting all aspects of your hospital and it is not going to get better anytime soon…

If you have an ED…

7


If you have an emergency department you are in the behavioral health business

Key issues facing most hospital ED’s: conditions

Lack of BH resources to triage and assess patients

Lack of separate space to treat patients

Lack of Psychiatrists to provide evaluations

Lack of referral options

Repeat customers

Increased length of stay in ED

If you have an ED…

8


If you have an emergency department you are in the behavioral health business

Resulting Impact: conditions

Extended wait times for all patients in ED

Increased diversion days or patients left without being seen

BH patients disruptive to care for others

Increased cost for security, sitters, etc.

Med/Surg beds used for most severe patients

Increased Re-admission rates

Basically a throughput issue across the house…

If you have an ED…

9


If you have an emergency department you are in the behavioral health business

Options: conditions

Extend the continuum

Behavioral Health ED/Access Center

Observation beds

Behavioral Health specific track

If you have an ED…

10


If you have an emergency department you are in the behavioral health business

What could a reduction in the BH patient ALOS in ED mean to a hospital….

Total ED Visits

Total BH Visits

ALOS Med patients

ALOS BH patients

Med/Surg admission rate

ED patients LWBS

If you have an ED…

65,350

5,500

4.5 hours

6.5 hours

17.0 %

1,200

11


If you have an emergency department you are in the behavioral health business

What could a reduction in the BH patient ALOS in ED mean to a hospital….

Assume a ½ hr. reduction in BH ALOS

Potential additional ED patients

Med/Surg Admission Rate

Additional Med/Surg admission

Net Revenue Opportunity

Net ED Revenue Opportunity

If you have an ED…

550

17%

96

$900,000$350,000

12


If you have an emergency department you are in the behavioral health business

Issues facing Hospital BH programs: a hospital….

Focused on Inpatient bed based services only

Patient needs have moved from custodial to active treatment

Many hospital programs not prepared for influx of chronic and forensic patients

Safety issues (patient and staff) increasing

ED the major source of patients

Medicare beds being used as general adult

Reimbursement for many patients reduced or non-existent

High number of short-term stays with increasing re-admission rates

If you have an ED…

13


If you have an emergency department you are in the behavioral health business

Does every patient presenting in ED require an Inpatient stay?

How many things are you doing in Med/Surg on the Outpatient side that were done on the Inpatient basis 10 years ago?

If you have an ED…

14


If you have an emergency department you are in the behavioral health business

Service Intensity stay?

More Less

If you have an ED…

Triage and Intake

Psych ICU

Unit

Crisis Unit

Med-Psych Unit

Gero-Psych Unit

Specialty Units

General Adult Unit

RTF Services

23-Hour

Observation

Transition

Services

PHP

½ Day PHP

& SOP

IOP

Individual & Family Therapy

Aftercare & Home Care

ECT

15


If you have an emergency department you are in the behavioral health business

Options? stay?

Continue as is…

Outsource Behavioral Health Evaluations and Assessments to 3rd party…

Close beds…

Fix and expand current programming…

If you have an ED…

16


If you have an emergency department you are in the behavioral health business

Continue as is… stay?

Can the hospital afford losses and additional costs

- Throughput issues

- Sitter/Security costs

- Program diminished performance

Liability and safety issues for patients and staff issues

Continued increase in re-admission rates

If you have an ED…

17


If you have an emergency department you are in the behavioral health business

Outsource Behavioral Health Assessments and Evaluations to stay?3rd party…..

May address Doctor to Doctor evaluation faster

Improves throughput for patients discharged to home

May improve throughput to existing programs

Does not improve disposition options. What do you do with the patient?

If you have an ED…

18


If you have an emergency department you are in the behavioral health business

Close beds stay?

Stop the immediate fiscal bleeding for an existing Inpatient unit

Potentially replace with med/surg service with better return

Reduce staff and patient safety issues on unit

What do you now do with those patients showing up in the ED?

If you have an ED…

19


If you have an emergency department you are in the behavioral health business

Fix and expand current programming… stay?

Are the beds utilized under the best designation?

Medicare Exempt Units (Distinct Part Unit) is reimbursed on a per diem vs. DRG

Medicaid days in a Medicare Exempt Unit do not count towards DSH

On average an increase of 1 Medicare ADC for a year should generate an additional $250,000 in net revenue for a Medicare Exempt Unit.

If you have an ED…

20


If you have an emergency department you are in the behavioral health business

Fix and expand current programming (continued) stay?

Are you meeting the needs within the community?

Do you have an adequate and working continuum?

Is your programming contemporary?

Is the staff training and credentials contemporary?

Do you have denial issues?

Are your psychiatrists aligned with the hospital?

Is your consultation coverage for the ED and Med/Surg units working?

A detailed assessment of your programs is a way to get a handle on these issues!

If you have an ED…

21


If you have an emergency department you are in the behavioral health business

As with many throughput issues it could be a combination of these various options!

If you have an ED…

22


If you have an emergency department you are in the behavioral health business

In closing: these various options!

Need for comprehensive behavioral health services increasing

State and local resources reduction not likely to be reversed in near term

Behavioral Health ED visits and ALOS increasing

Hospitals are being left to address the issue and need a comprehensive strategy

If you have an ED…

23


If you have an emergency department you are in the behavioral health business

Contact Information: these various options!

James J. Free

Senior Vice President, Business Development

Diamond Healthcare Corporation

(800) 443-9346

jfree@diamondhealth.com

If you have an ED…

24