Greetings from sunny Clearwater Beach, Florida – where we just wrapped up The OPEN MINDS Integration Summit: New Models For Primary Care, Behavioral Health & Social Service Integration. Wow! So much to unpack, we’re sure to revisit the lessons learned at this Summit in subsequent briefings. But at a high-level, it was made clear by OPEN MINDS Senior Associate John Talbot and by two of his fellow presenters Joel Hornberger, MHS, chief strategy officer and national training and consulting director at Cherokee Health Systems and Tine Hansen-Turton, president and chief executive officer of Woods Services, Inc., that the integration of behavioral and physical health isn’t a fad, it’s an evolving trend that is reshaping how health care is provided (see How VBR Prioritizes Primary Care As The ‘Center’ Of Integration). The other two presenters, Donald Parker, president of Hackensack Meridian Health, Carrier Clinic, and Annette Lusko D.O., chief medical officer of Community Bridges Inc., gave insights into how the need to integrate changed the way they did business. Stay tuned. What is clear is that provider organization executives must consider where they are on the integration continuum and map out a plan for identifying (or develop) the integration model that works best for where the organization is (see All Integration Is Not The Same).
The key takeaways from the discussion? Sustainability and specialization. There is no one right way to integrate, and not one universal definition of integration. While some provider organizations elect an integrated care model out of necessity, others create an innovative model for growth and sustainability. Those points were driven home during part of today’s session – but throughout the day we heard there are four factors for successful integration; collaboration, communication, commitment, and access to care. (In follow up briefings, we’ll explore the four factors more thoroughly with additional insight from our other presenters.) Ultimately, the key is sustainability and specialization – no integrated program can be all things to all consumers. Rather, I believe integrated care will become specialty integrated care, meeting the needs of a selected population such as consumers with cancer, diabetes, heart disease, multiple chronic complex conditions, or children (see Are You Ready For Whole-Person Care? Know The Performance Measures That Matter).
Integration For Survival & Sustainability
Cherokee Health System went from being a “tiny Community Mental Health Center in rural Appalachia” to an integrated care model that remained rooted in mental health … its focus always had been on the Severely and Persistently Mentally Ill (SPMI) … but expanded into primary care “in a big way” that is now the fifth largest FQHC in Tennessee with an innovative model of successful care integration emulated by others. Mr. Hornberger pointed out that, to survive in a value-based era and to meet the complex care needs of its very rural consumer population, the organization needed to expand into primary care – and learn the business as quickly as possible. Today, the organization uses a behaviorally enhanced health home model with a multidisciplinary team approach that is centered around a behaviorist and consulting psychiatric professional on the primary care (PC) team.
He also emphasized that integrated behavioral health must still fulfill the functions of primary care – operating as the first line of access to treat any consumer that comes through the door. At the same time, the care must not only be organized, but include all elements within each episode of care. To support this new type of infrastructure, the PC team shares their physical space, as well as their support staff and clinical workflows to enhance documentation, communication, and treatment planning.
Specialization In Integrated Care
As the industry shifts towards specialty integrated care, provider organizations are going to have to pick a lane to swim in, build a team for the health care relay, and stay in that lane. That’s exactly what Woods Service Inc. did electing to adopt a population health framework – an approach that seeks to improve the well-being of one population. For Woods—a non-profit with locations in Pennsylvania and New Jersey—that population is focused on those with intellectual and developmental disabilities (I/DD) and complex medical and behavioral health issues. Woods serves over 22,000 youth and adults with complex needs that range from brain injury, to autism, to mental health and addiction. Ms. Hansen-Turton underscored the necessity of adopting the new approach, noting that most individuals with I/DD and a dual diagnosis receive little no to supports.
The Medical Center at Woods provides a variety of services, just a few include primary health care, neurology, psychiatry, dentistry, and telemedicine. To support the model, the organization uses an electronic medical record to enhance communication with the interdisciplinary team. In partnership with Keystone First, Woods launched the first patient-centered medical home (PCMH) for individuals with I/DD and acquired brain injuries.
It was all hands on deck for the closing panel, with the four presenters joined by Lisa Kay, clinical program manager of Cigna, and Michael Lawton, chief executive officer of United Healthcare Community Plan of Florida. There was the general agreement that there is no one “correct” model for integration, and that the primary goals of every integration model are the same: Better population health management, greater access to care, improved consumer outcomes, and lower costs (see Integration—Strategic Threat (& Opportunity) For Specialists and For Successful ‘Integration’, It Takes Interoperability & Patience). Making the transformation toward specialty integrated care is and will continue to be critical for payers and provider organizations – especially those serving complex consumer populations. Following in the footsteps of successful organizations will ensure you have the necessary tools for a sustainable integration strategy in the long-term.
For more on innovation in integrated care, check out these resources in the OPEN MINDS Circle Library:
- The Power Of Real-Time Clinical Data In Integrated Care
- Opportunities To Advance Risk In Integrated Care
- Your Digital Tech Integration Checklist
- The Changing Face Of Integration
- Managing A Holistic Approach To Care: Integrating Physical, Behavioral & Social Health Data
- 3 Keys For Success With Integrated Service Delivery
- Will Health Plan Backward Integration ‘Remake’ Specialty Care?
- Integration Strategies For The Complex Consumer Market
- Making Managed Care Work For Complex Consumers
- Primary Care—The More Things Change…
For more live coverage from Clearwater Beach this week, stay tuned as we report on The 2020 OPEN MINDS Performance Management Institute and check out live coverage of the entire event on social media – @openmindscircle.