Massachusetts Health Policy Commission
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This summer newsletter features the Health Policy Commission’s ongoing support of work that advances behavioral health integration within medical care systems in the Commonwealth. We are pleased to share the announcement of awards in the HPC’s newest investment program, the SHIFT-Care Challenge. SHIFT-Care awards will fund initiatives focused on addressing the health-related social needs of complex patients and providing timely access to behavioral health services, particularly evidence-based treatment for opioid use disorder. This edition also highlights HPC awardees, the Brookline Center for Community Mental Health and Beth Israel Deaconess Hospital-Plymouth, and their work on integrating behavioral health care for their patie
nts. Finally, we are excited to announce the upcoming release of several HPC publications:
profiles of the 17 HPC-certified Accountable Care Organizations (ACOs).and a policy brief “Transforming Care: How ACOs in Massachusetts Manage Population Health.”
Let us know if there are other care delivery transformation topics or work in the Commonwealth that you would like to see the HPC showcase in this newsletter. We'd love to hear from you! Email us at
caredeliverytransformation@mass.gov
.
Regards
Team HPC
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The SHIFT-Care Challenge: HPC Announces 15 Awardees Selected to Implement Innovative Care Delivery Models across the Commonwealth
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The HPC Board approved 15 awardees for the
SHIFT-Care Challenge
at the agency’s July 18th public meeting. Through SHIFT-Care, the HPC will distribute nearly $10 million in funding to innovative care delivery transformation initiatives from Massachusetts providers. Representing each region of the Commonwealth, SHIFT-Care Challenge initiatives aim to reduce avoidable acute care utilization by investing in evidence-based, innovative care delivery models that are community-based, collaborative, and sustainable. Awardee initiatives are focused on addressing the health-related social needs of complex patients or providing timely access to behavioral health services. A description of each initiative’s care model can be found
here
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The SHIFT-Care Challenge is intended to foster stronger partnerships between community-based organizations and health care providers, including ACOs and hospitals. The goal is also to contribute to the emerging evidence that addressing health-related social needs and providing timely access to behavioral health services can result in overall cost savings to the health care system, through a reduction in acute care utilization. The HPC anticipates programs launching in late fall 2018.
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Addressing the health-related social needs of complex patients.
The goal of these projects is to support innovative care models that address health-related social needs of complex patients to prevent avoidable admissions, readmissions, emergency department (ED) visits, and/or ED revisits.
The HPC is funding five awards with this focus, totaling $3,288,234:
- Community Care Cooperative (C3)
- Boston Medical Center
- Hebrew SeniorLife
- Baystate Health Care Alliance
- Steward Health Care Network, Inc.
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Providing timely access to behavioral health services.
These awards support innovative models that enable timely access to behavioral health services in order to prevent avoidable admissions, readmissions, ED visits, and/or ED revisits. A majority of these initiatives focuses specifically on expanding access to treatment for opioid use disorder by implementing models of care that initiate evidence-based pharmacologic treatment in the ED and connect patients to outpatient services for ongoing treatment.
The HPC is funding ten awards with this focus totaling $6,467,066:
- Holyoke Health Center
- Lowell General Hospital
- Massachusetts General Hospital
- North Shore Medical Center
- UMass Memorial Medical Center
- Beth Israel Deaconess-Plymouth
- Addison Gilbert/Beverly Hospitals
- Harrington Memorial Hospital
- Mercy Medical Center
- Holyoke Medical Center
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The Brookline Center for Community Mental Health: Strong, Effective Communication and
Partnership
As an awardee of the HPC's
Targeted Cost Challenge Investment (TCCI)
program, the Brookline Center for Community Mental Health (BCCMH) has partnered with the Beth Israel Deaconess Care Organization (BIDCO), an HPC-certified ACO, and Springwell, an Aging Services Access Point (ASAP). Their initiative aims to reduce total health care expenditures by 15% for adult patients of BIDCO with a chronic medical condition and a behavioral health condition. To achieve this goal, BCCMH deploys a mobile multidisciplinary care management team to integrate behavioral health, primary care, and health-related social needs such as housing. This TCCI-funded work builds on the successful “Healthy Lives” pilot program that these partners collaborated on previously.
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Beth Israel Deaconess Hospital-Plymouth: Care Coordination through CHART
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Thr
ough the
CHART
program, the HPC supported Beth Israel Deaconess (BID) Hospital-Plymouth’s initiative to reduce readmissions for patients with dual eligibility for Medicare and Medicaid and to reduce ED revisits for patients who visit the ED with a primary behavioral health diagnosis. Members of the BID-Plymouth CHART team shared a patient story highlighting how their programs co
ordinated care for patients with complex medical and behavioral health needs to improve patient outcomes and experience.
The patient was a young adult with co-occurring substance use disorder (alcohol and IV heroin use), complex mental health needs, and serious chronic medical conditions. The patient began using alcohol at a young age, and had only experienced sobriety while briefly in jail and on probation. Despite efforts to connect to behavioral health providers, he faced challenges in achieving consistent attendance at those appointments. He also repeatedly visited the ED which often resulted in hospital admissions.
When he was identified for the program, he was so ill that he could barely complete the outpatient behavioral health intake assessment. Recognizing an opportunity to coordinate and accelerate care for the patient, the CHART program’s social worker coordinated with his PCP’s assistant, and was able to offer expedited access to the appropriate specialist. This not only provided needed care, but demonstrated the CHART team’s dedicated efforts to support the patient.
Following these care coordination efforts, the patient was much more receptive and engaged with the CHART team, completing behavioral health visits with the team’s social worker and nurse practitioner. He attended biweekly therapy sessions, and started antidepressant medication. Though he was initially unwilling to engage in Alcoholics Anonymous or take medication to help with alcohol cravings, as his overall health, anxiety and mood improved, he was receptive to trying medication for alcohol dependence and responded positively.
The patient experienced additional benefits, and appeared to be less socially isolated, more connected with family and friends, less stressed, and quit smoking. Several months after engaging with the CHART team, the patient has not had any return visits to the hospital. His PCP reported that his physical health was stable and that his chronic conditions were well controlled, a remarkable achievement considering the complex interaction between his medical and behavioral health conditions.
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PUBLICATIONS, PRESENTATIONS, & RECOGNITIONS
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Coming Soon: ACO Certification Policy Brief on Population Health Management
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The HPC is pleased to announce the forthcoming publication of a new policy brief “Transforming Care: How ACOs in Massachusetts Manage Population Health”. The second in a series reporting findings from the
HPC ACO Certification program
, this latest brief describes how ACOs routinely conduct risk stratification to understand their patient population needs and to implement programs designed to address those needs, particularly in the areas of behavioral health and social determinants of health. The brief concludes with some recommendations for how providers, payers, and policy makers can support more effective population health management approaches and programs.
The HPC is also preparing to publish ACO Profiles – one-page descriptions of the 17 HPC-certified ACOs. Each profile will provide basic information about the ACO, such as the payers with which it has risk contracts and whether it is anchored by a physician group, teaching hospital, or community hospital, based on publicly-reported information submitted to the HPC in 2017 ACO Certification applications. Where applicable, the profiles will also provide data about the larger health system of which the ACO is a part, sourced from 2017 Massachusetts Registration of Provider Organizations (RPO) filings.
The HPC expects to post the policy brief and profiles on our
website
later this summer. Visit the site now to read the first ACO Policy Brief and view other resources on the ACO Certification program.
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UPCOMING EVENTS & SUMMER READING
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CHCS, RWJF
Webinar
August 16, 2018
12:30pm - 2:00pm EST
NASADAD
Boston, MA
August 28 - August 30, 2018
All day
MHA
Webinar
September 11, 2018
1:00pm - 2:30pm EST
MHA
Webinar
September 14, 2018
8:30am - 3:00pm EST
MHA
Framingham, MA
September 27, 2018
8:00am - 2:30pm EST
Harvard Medical School Center for Primary Care and Philadelphia College of Osteopathic Medicine
Boston, MA
October 5, 2018
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Summer is a great time to catch up on your reading! We’d like to offer the following publications and books to add to your list:
Being Mortal: Medicine and What Matters in the End by Atul Gawande
Dreamland: The True Tale of America’s Opiate Epidemic by Sam Quinones
Prescription for the Future: The Twelve Transformational Practices of Highly Effective Medical Organizations by Ezekiel J. Emanuel
Saving Gotham: A Billionaire Mayor, Activist Doctors, and the Fight for Eight Million Lives by Tom Farley
Stories from the Shadows: Reflections of a Street Doctor by James J. O'Connell
The American Health Care Paradox: Why Spending More is Getting Us Less by Elizabeth H. Bradley and Lauren A Taylor
Women in Science: 50 Fearless Pioneers Who Changed the World by Rachel Ignotofsky
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Health Policy Commission
50 Milk Street, 8th Floor
Boston, MA 02109
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