Health Innovations                                                                                          August  2017
SIM: Continued success on the horizon

The Colorado State Innovation Model (SIM) team had a productive site visit with federal partners from the Centers for Medicare & Medicaid Innovation (CMMI) last month, and are eager to welcome cohort-2 practices into the fold this September.

The two-day visit with CMMI included presentations from SIM providers, university partners, local public health agency representatives and regional health connectors, who shared practical perspectives on what it takes to integrate behavioral and physical health in primary care settings, to reduce mental health stigma and to help providers capitalize on community resources. CMMI leadership asked thoughtful questions and appreciated the opportunity to hear different perspectives on the work underway in Colorado. The team also shared demographics for practices accepted into cohort 2, which helps round out the SIM presence in the state, and data that shows progress among cohort-1 practices. Click here to see the map that includes SIM cohorts 1 and 2 practices.

As we prepare to welcome cohort 2, the SIM team is preparing to launch its last application for cohort 3 this winter. Please encourage primary care providers to apply and capitalize on this opportunity to receive valuable coaching and guidance to deliver whole-person care and test alternative payment models. Stay tuned for more information.

Successfully integrating care improves patient’s life

The Colorado State Innovation Model is working with four community mental health centers (CMHCs) during the initiative’s four-year time frame to integrate physical health into mental health settings. In addition, SIM will help 400 primary care practice sites integrate behavioral and physical health. The ability to deliver this type of “whole-person care” has been shown to improve patient outcomes as illustrated in the short example below. Learn more about the CMHCs and the innovative work underway in the SIM podcast series.

CMHC example: A patient who receives care at one of the SIM-funded CMHC sites had an A1C level that was so high it was off the charts or “unreadable,” according to a primary care provider. As background, A1C is a common test of blood sugar levels used to diagnose and monitor type 1 and type 2 diabetes. A normal A1C level for someone without diabetes is below approximately 5.7%, a value of 8% indicates uncontrolled diabetes, and a level of 7% or lower is a common treatment target for someone with diabetes.

After one month the patient’s A1C dropped to 10% and then to 6% after two months of working with a team that comprised the patient, a federally-qualified health center (FQHC) nurse, a behavioral health professional, and a health coach. The team created a plan that included daily appointments with an FQHC nurse for insulin injections. The patient developed a strong relationship with the nurse, which helped the patient engage in care, discuss diet and exercise options, and learn to self-administer the injections. The patient’s diabetes is now well-controlled, which marks a true success for integrated care.

SIM small grants helps create electronic patient registries

Get a quick overview of how some SIM practices are using electronic patient registries to streamline their approach to specific patient populations and address care gaps in the latest small grant article series. Don’t miss the previous stories about hiring behavioral health clinicians and making electronic screenings a reality across the state.

New learning module available: Psychotropic medications

Get help ensuring that young patients receive appropriate treatment and medication with the most currently published Psychotropic Medication Guidelines for Children and Adolescents in Colorado’s Child Welfare System. This new training model, which was created by the Office of Behavioral Health with SIM funding, will help your practice in the following areas:

  • Recognize the issues for foster care kids surrounding the use, maintenance and monitoring of psychotropic medication as treatment in care plans.
  • Recognize and adhere to safeguards to avoid over prescribing, relative contraindication, and dosing.
  • Identify resources to ensure relevant and current prescribing and treatment.

This module is valuable for clinicians, practice staff, behavioral health, foster care providers, patient advocates, front and back office, nursing, care managers, and school representatives.

SIM releases rapid-cycle feedback report

Read the latest installment of these rapid-cycle feedback reports, which provide the SIM team and its stakeholders with actionable feedback that informs program implementation. Each report focuses on a specific component of SIM and this one, which covers January through March 2017, features key informant interviews with SIM practice facilitators and clinical health information technology advisors.

Last chance to apply for TCPi

The deadline to sign-up for the Transforming Clinical Practice Initiative (TCPi), which helps healthcare providers succeed with alternative payment models through valuable coaching and guidance, is Sept. 29. There are more than 1,600 physicians participating in the initiative, which can support 2,000 providers in the state. Learn more about TCPi and apply today before time runs out.

Costs and outcomes of mental health and substance use disorders in the US
This Visualizing Health Policy infographic from the Journal of the American Medical Association looks at costs and outcomes of mental health and substance use disorders in the United States (US). Nearly 18% of adults reported having a mental, behavioral, or emotional disorder in 2015, including more than 1 in 5 women. Furthermore, nearly 3% of people aged 12 years or older reported addiction to or misuse of an illicit drug in 2015, including more than 7% of people aged 18 to 25 years. However, 1 in 5 people say they or a family member had to forego needed mental health services because they couldn’t afford the cost, their insurance wouldn’t cover it, they were afraid or embarrassed, or they didn’t know where to go.
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RHCs connect providers to community resources

Regional Health Connectors (RHCs) across the state are finalizing their areas of focus for the work they will complete during the next two years. If you haven’t already connected with your RHC, get contact information here. Learn more about the RHC program and some of the work they’re doing in the SIM podcast.
CIVHC and the Colorado Business Group on Health partner to help employers reduce health care costs
The Colorado Business Group on Health (CBGH) and the Center for Improving Value in Health Care (CIVHC) are partnering to provide new data and analytic support to employers across the state. By combining services, the two non-profit organizations intend to bolster the work of employers seeking to lower health costs and improve the health of their employees. Read the full press release for more information.

Become a Mental Health First Aid Colorado instructor

If you’re interested in helping expand Mental Health First Aid (MHFA) in your community, we encourage you to become an instructor. MHFA is an evidence-based, internationally recognized training program that helps citizens identify mental health and substance use challenges, connect individuals to care, and safely de-escalate health crisis situations. Mental Health First Aid instructors make a difference in their communities by empowering individuals to care for themselves and for each other. The program is offered by the Colorado Behavioral Healthcare Council and Mental Health First Aid Colorado in partnership with the Colorado Department of Human Services and the Office of Behavioral Health. Click here to apply and learn more

Suggested reading
There has been a rise in suicide according to the April of 2016 Center for Disease Control and Prevention Report the number of suicides in the United States has been on the rise since 1999 in everyone between the ages of 10 and 74, with greater annual percent increases after 2006. In 2014, 13 people out of every 100,000 took their own lives, compared with 10.5 per 100,000 in 1999. The suicide rate increased every year from 1999 to 2014 among both women and men and in every age group except those 75 and older.

A three-story, 50,000 square-foot building with 60 one-bedroom furnished apartments and on-site staff will soon open to help Denver's homeless. The Sanderson Apartments, located at 1601 S. Federal Blvd., is the largest supportive housing project for the Mental Health Center of Denver.