“Urgent care” for behavioral health is in demand. Why? Mental health admissions are still proving a big proportion of hospitalizations.
In 2010, expenses for hospital inpatient stays accounted for nearly one-third of all health care expenses for the U.S. civilian noninstitutionalized population ($1.3 billion) (see Expenses for Hospital Inpatient Stays, 2010) – and an annual average of 27.5 million adults (14.3%) had some health care expenses for mental health disorders ($48.2 billion). This includes $7.95 billion for inpatient stays, and $850 million for emergency room visits (see Expenditures for Mental Health among Adults, Ages 18-64, 2009-2011).
Also not surprisingly, 33% of “superutilizers” of resources have behavioral health claims (see Superutilizers & Mental Illness). In addition, the 2012 30-day readmission rates for psychiatric hospitalization were 9% among people admitted for mood disorders (847,000) and 15.7% (383,000) for people admitted for schizophrenia (see Psychiatric 30-Day Readmission Rates Were 9% For Mood Disorders; 15% For Schizophrenia).
So what does “urgent care” for behavioral health look like? I had a chance to look at a new model presented by two Monarch Behavioral Health executives, Jason Cagle, HIT Manager, and Chris Thompson, Senior Clinical Operations Director, in their session, Becoming The Urgent Care For Behavioral Health: Leveraging Technology To Empower A New Service Delivery Model, at the 2015 OPEN MINDS Strategy and Innovation Institute. The model – called Open Access and adopted in 2012 – accommodates a high volume of walk-in traffic to its facilities in addition to its scheduled appointments. It’s designed to maximize scheduling efficiencies and moving walk-in consumers through six specific steps in one visit – walk-in, triage, intake, comprehensive clinical assessment (CCA), psychological evaluation, and prescription (if needed).
The key to executing this model is technology. The first is a “single data entry” system the team developed in-house. The second is their electronic health record (the Visual Health Record/Clinician’s Desktop developed by The Echo Group) that seamlessly interfaces with Monarch’s existing technology and queues individuals in a timely fashion. The third technology is a “hub” telemedicine model that allows staff to find openings for same-day services, around the network (not just the location the consumer walked into).
How is the system staffed and how does the system work? Clinical professionals don’t carry full case-loads, but also see consumers as they walk in. And, the data reporting system developed in the Visual Health Record can identify the specific key performance indicators (KPIs) needed for the Clinical professionals to make continued adjustments and improvements to services. The Open Access service model has proven successful for Monarch as the number of walk-ins grew from 138 walk-ins in October 2012 to 2,539 walk-ins in October 2014 — a 1,726 percent increase. Staff productivity has kept pace.
Monarch uses Medicaid, Medicare, State Insurance, and various third party insurance to pay for the services that are provided for Open Access. In some cases, funders will provide additional funds to help provide the service because of the need in the community.
These types of innovative programs – which address the needs of high-cost consumers when they need it – are the future of all of health care. For a look at other examples of innovative programming, check out a few selections from the last few weeks, from the OPEN MINDS Industry Bulletins: Service & Treatment Updates:
- Father Martin’s Ashley & University Of Maryland Upper Chesapeake Medical Center Open Outpatient Treatment Program
- Beacon Health Options Now Provides Quality Mental Health Care & Substance Use Disorder Services To West Virginia Family Health Plan Medicaid Members
- New Mexico Announces Expansion Of Mental Health Crisis Hotline
- ComForCare Launches Joyful Memories Music Program For Dementia Patients
- Presbyterian Senior Living To Open First ‘Small House’ Facility
For more on developing your next service line, make sure to join my colleague Joseph P. Naughton-Travers, Ed.M. for his 2015 OPEN MINDS Executive Leadership Retreat, Diversification & New Service Line Development, on September 23.