Abstract
Care coordination and care management are essential for persons with multiple conditions receiving care from multiple providers to receive high-quality care that results in reduced morbidity, mortality, and costs. The majority of persons with behavioral health conditions have multiple conditions both behavioral and general medical. Interactions with these patients constitute the majority of visits of most healthcare providers. Behavioral health, general medical providers, and payers of healthcare cannot meet the expected standards of care without actively implementing in participating in care coordination and care management. Advanced models of care coordination are discussed including primary care case management, health homes for chronic conditions, certified community behavioral health centers, and Medicare care management bundled payments.
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References
Bartels SJ, Clark RE, Peacock WJ, et al. (2003). Medicare and Medicaid costs for schizophrenia patients by age cohort compared with costs for depression, dementia, and medically ill patients. American Journal of Geriatric Psychiatry, 11(6), 648–657.
Center for Health Care Strategies, Inc. (2007). Care Management Framework. Last accessed on April 5th, 2022 at: https://www.chcs.org/media/Care_Management_Framework.pdf
Centers for Medicare and Medicaid Services. (2010). SMDL# 10-024 ACA# 12. Re: Health Homes for Enrollees with Chronic Conditions.
Centers for Medicare and Medicaid Services. (2022). https://www.medicaid.gov/medicaid/long-term-services-supports/healthhomes/index.html#:~:text=Chronic%20conditions%20listed%20in%20the,target%20health%20home%20services%20geographically
Center for Medicare and Medicaid Services Medicare Learning Network (2019). Chronic Care Management Services. Accessed on April 5th, 2022 at: https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/chroniccaremanagement.pdf
Clements J. (2020). Learn About Billing Medicare’s New Principal Care Management Codes. Outsource Strategies International. Accessed on April 5th, 2022 at: https://www.outsourcestrategies.com/blog/learn-about-billing-medicares-new-principal-care-management-codes.html
Colton, CW & Manderscheid RW (2006). Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Preventing Chronic Disease: Public Health Research, Practice, & Policy, 3(2), 1–14.
Daumit GL, Anthony CB, Ford DE, et al. (2010). Pattern of mortality in a sample of Maryland residents with severe mental illness. Psychiatry Research, 176(2–3), 242–245.
Fondow M, Pandhi N, Ricco J, et al. (2015). Visit Patterns for Severe Mental Illness with Implementation of Integrated Care: A Pilot Retrospective Cohort Study AIMS Public Health; 2(4): 821–831.
Ford JD, Trestman RL, Steinberg K, et al. (2004). Prospective association of anxiety, depressive, and addictive disorders with high utilization of primary, specialty and emergency medical care. Social Science & Medicine, 58(11), 2145–2148.
Jones DR, Macias C, Barreira PJ, et al. (2004). Prevalence, severity, and co-occurrence of chronic physical health problems of persons with serious mental illness. Psychiatric Services; 55:1250–1257.
Lutterman T, Ganju V, Schacht L & Monihan K (2003). Sixteen State Study on Mental Health Performance Measures. DHHS Publication No. (SMA) 03-3835. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration.
McDonald KM, Sundaram V, Bravata DM, et al. (2007). Care coordination. In: Shojania KG, McDonald KM, Wachter RM, and Owens DK, eds. Closing the quality gap: A critical analysis of quality improvement strategies. Technical Review 9 (Prepared by Stanford-UCSF Evidence-Based Practice Center under contract No. 290-02-0017). Vol. 7. Rockville, MD: Agency for Healthcare Research and Quality. AHRQ Publicatioen No. 04(07)-0051-7.
Melek SP, Norris DT & Paulus J et al. (2018). Milliman American Psychiatric Association Report; Potential economic impact of integrated medical-behavioral healthcare. Retrieved on April 4th, 2022 at: https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/Integrated-Care/Milliman-Report-Economic-Impact-Integrated-Implications-Psychiatry.pdf
Mental Health America, Alexandria; VA, Mental Health America (2007). Communicating About Health: A Mental Health America Survey of People with Schizophrenia and Providers.
Morden NE, Mistler LA, Weeks WB, et al. (2009). Health care for patients with serious mental illness: family medicine's role. J Am Board Family Med; 22:187–195.
Parks JJ (2015). Health Homes. In Raney, L. (ed.), Integrated Care: Working at the Interface of Primary Care and Behavioral Health (pp.193–216). Washington, DC: American Psychiatric Press, Inc.
Parks JJ & Minkov K (2015). Primary Health-Behavioral Health Integration for the Population of Individuals with Serious Mental Illness. In O’Donohue. W.T. (ed.), Integrated Primary and Behavioral Care: Role in Medical Homes and Chronic Disease Management (pp.171–199). New York, NY: Springer Publishing.
Parks JJ, & Pollack D (2004). Integrating behavioral health and primary care services: Opportunities and challenges for state mental health authorities: Eleventh in a series of technical reports. Alexandria, VA: National Association of State Mental Health Program Directors. Retrieved from http://www.nasmhpd.org/general_files/publications/med_directors_pubs/Final%20Technical%20Report%20on%20Primary%20Care%20%20Behavioral%20Health%20Integration.final.pdf
Parks JJ, Swinfard T and Stuve P (2010). Mental Health Community Case Management and Its Effect on Healthcare Expenditures. Psychiatric Annals, 40 (8); pp. 415–419.
Parks JJ, Svendsen D, Singer P, & Foti ME (eds.) (2006). Morbidity and mortality in people with serious mental illness: Thirteenth in a series of technical reports. Alexandria, VA: National Association of State Mental Health Program Directors Council. Retrieved from http://www.nasmhpd.org/general_files/publications/med_directors_pubs/Technical%20Report%20on%20Morbidity%20and%20Mortaility%20-%20Final%2011-06.pdf
SAMHSA-HRSA. (2012). Behavioral Health Homes for People With Mental Health & Substance Use Conditions – The Core Clinical Features”; SAMHSA-HRSA Center for Integrated Health Solutions; Available at HYPERLINK “https://urldefense.com/v3/__https:/www.thenationalcouncil.org/wp-content/uploads/2021/04/CIHS_Health_Homes_Core_Clinical_Features.pdf__;!!NHLzug!MlgRl1XxBMKNFay9pZslm8PsdA15IAtYZoCAf1YoZVxHYfnYxOL1DcdbN44ByOViwQuHNIzgenTRt97I1iXvIds$” https://www.thenationalcouncil.org/wp-content/uploads/2021/04/CIHS_Health_Homes_Core_Clinical_Features.pdf, Accessed September, 2022.
Sokal J, Messias E, Dickerson FB, et al. (2004) Comorbidity of medical illnesses among adults with serious mental illness who are receiving community psychiatric services. J Nervous Mental Disease; 192:421–427.
Spillman BC, Allen EH (2017). Evaluation of the Medicaid Health home option for Beneficiaries with Chronic Conditions: Evaluation of Outcomes of Selected Health Home Program, Annual Report – Year Five. Urban Institute.
Substance Abuse and Mental Health Services Administration (2016). Criteria for the Demonstration Program to Improve Community Mental Health Centers and to Establish Certified Community Behavioral Health Clinics. Rockville, MD: SAMHSA
Townley C & Takach M (2012). Developing and implementing the Section 2703 health home state option: state strategies to address key issues. http://nashp.org/sites/default/files/health.home_.state_.option.strategies.section.2703.pdf
Wishon-Siegwarth A, Miller R Little J, et. al. (2020). Implementation Findings from the National Evaluation of the Certified Community Behavioral Health Clinics Demonstration-September 2020. Mathematica Policy Research, Prepared for Office of Behavioral Health, Disability, and Aging Policy Office of the Assistant Secretary for Planning and Evaluation U.S. Department of Health and Human Services Contract #HHSP233201600017I
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Parks, J.J. (2022). Service Coordination and Health Homes. In: Sowers, W.E., McQuistion, H.L., Ranz, J.M., Feldman, J.M., Runnels, P.S. (eds) Textbook of Community Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-031-10239-4_40
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