By Michele Ganote
On March 5, the Kentuckiana Health Collaborative’s annual conference moves from a broad-based view of value-based healthcare innovation to a deep dive into what many would say is Kentucky’s most important healthcare priority–behavioral healthcare.
This conference will examine how employers, payers, and providers can ensure individuals have access to timely, appropriate mental health services and treatment, through the latest advancements in value-based behavioral healthcare.
Costly and Prevalent
Mental health and substance use disorder continue to rise to the top of many healthcare purchasers’ costliest and most prevalent conditions. Yet, these conditions are not treated by plans and providers the same way as physical health conditions.
In fact, mental health is the only chronic disease in America that is not treated until Stage IV. And individuals facing substance use disorder continue to receive treatment that does not comply with current medical recommendations.
Research consistently demonstrates smaller payments to behavioral health providers and higher out-of-network use for patients with mental health and substance use disorders, despite parity being law. All of these barriers create a system that often does not meet individuals’ behavioral healthcare needs.
Flawed Mental Health
The conference kicks off with Paul Gionfriddo, president and CEO of Mental Health America. Gionfriddo will provide an overview of mental health status and access in the United States, with a personal reflection on how, through policy decisions, he helped create a flawed mental health system that has failed millions, including his son.
Dr. Stephen O’Connor, University of Louisville Department of Psychiatry and Behavioral Sciences, will moderate four panelists, who will discuss several drivers and contributors to poor mental health often overlooked:
- Joseph Bargione, a school psychologist, discussed how healthcare networks can address adverse childhood experiences (ACEs) in patients.
- Danesh Mazloomost, anesthesiologist and pain management specialist, discussed a new framework for treating pain that avoids addiction and has better outcomes.
- Aja Barber from Louisville Metro’s Center for Health Equity explained how the relationship between mental health, social determinants of health and institutionalized systems of power/oppression keep us from experiencing the kind of world we all deserve.
- Allison Tu, StAMINA and student at duPont Manual High School, shared youth insights into the factors influencing mental health from a series of focus groups conducted with high schoolers across Kentucky.
Mike Thompson, president and CEO of the National Alliance of Healthcare Purchaser Coalitions, will discuss the roadmap and checklist his organization developed for employers to use in designing high value behavioral healthcare. All attendees will receive a copy of the roadmap, which includes an assessment of current performance of health plans and behavioral health organizations across key areas.
New Payment Models
A light continues to shine on the fact that many patients do not get appropriate treatment for substance use disorder. As a result, two new payment models have been designed to help incent effective treatment and recovery.
Dr. Kelly Clark, an addiction psychiatrist and the President of the American Society of Addiction Medicine, will present the new Patient-Centered Opioid Addiction Treatment (P-COAT). The model is designed to increase the utilization of office-based treatment of opioid use disorder by providing adequate financial support to successfully treat patients and broaden the coordinated delivery of medical, psychological, and social support services.
David Smith from Third Horizon Strategies will discuss the new Addiction Recovery Medical Home (ARMH) receiving significant national attention. The model establishes a continuum of care from the time a patient enters an acute-care setting and is diagnosed with a substance use disorder through their recovery process. ARMH incorporates quality payments and bonuses for achieving certain outcomes and cost savings.
Telehealth Behavioral Health
Telehealth has quickly gained the attention of employers and payers working to increase network adequacy of medical and behavioral health providers. Commissioner Jenny Goins presented examples of how Kentucky’s Department of Employee Insurance has implemented telehealth behavioral health along with the data related to utilization and financial savings.
-Michele Ganote is with the Kentuckiana Health Collaborative in Louisville, Ky.