Friday, October 11, 2013

Opinion: A path to pay for integrated health care.

Opinion: A path to pay for integrated health care

By Edie Sonn

Integrating physical and behavioral care is good health policy — and it’s good for health.
The Institute of Medicine acknowledged that in 1996, when it advocated an integrated approach to primary care that would address physical, mental and emotional, and social functioning. And primary care providers see the importance of this every day.

Patients’ mental and physical health problems are interwoven, especially for the chronically ill. The vast majority of patients with chronic diseases such as diabetes, congestive heart failure, asthma, lung disease and others have co-occurring mental health and/or substance use issues. And there is significant evidence that integrating primary and behavioral health care leads to improved outcomes and reduced costs of care.

Yet few payers, either public or private, pay for integrated care. Why is that, and what can be done to change it?

A new report from the Center for Improving Value in Health Care  explores these questions. Using findings from interviews with key stakeholders, as well as information from successful integrated care programs around the country, the report, ”Paying for Integrated Care and Behavioral Health: Identifying Barriers and Developing Strategies to Overcome Them,” examines the challenges that both providers and payers face and presents recommendations for addressing those.

The report comes at an opportune time. The State of Colorado is developing its State Healthcare Innovation Plan using a pre-testing award under the State Innovation Model (SIM) program initiative from the Centers for Medicare and Medicaid Innovation. That plan centers on integrating primary care and behavioral health within new payment models, and aligning those payment approaches between Medicaid and commercial health plans.

Some findings from the report provide useful insights into the development of the SIM plan, including: CONTINUE READING AT SOURCE