New Whiteboard Video - DSRIP Year 4

In the video titled, "DSRIP Year 4: Start a Movement," New York State Medicaid Director, Jason Helgerson, gives an overview of the DSRIP year 4 theme and goals including the focus on performance, the move to Value Based Payment, and planning for the future.   To view the video, click here .

Policy Brief on Re-Entry of Persons with SMI and Complex Needs

California Health Policy Strategies published a detailed report examining the medical and behavioral health needs of people who are reentering their communities following incarceration. The authors make recommendations on how to overcome barriers to improving care and lowering costs, especially for those who have complex care needs, a serious mental illness, or both. 

Click here to view the report.

How Many Opioid Overdoses Are Suicides?

Mady Ohlman was 22 on the evening some years ago when she stood in a friend's bathroom looking down at the sink.

"I had set up a bunch of needles filled with heroin because I wanted to just do them back-to-back-to-back," Ohlman recalls. She doesn't remember how many she injected before collapsing, or how long she lay drugged-out on the floor.

"But I remember being pissed because I could still get up, you know?"

She wanted to be dead, she says, glancing down. A wisp of straight brown hair slips from behind an ear across her thin face.

At that point, says Ohlman, she'd been addicted to opioids - controlled by the drugs, she says - for more than three years.

"And doing all these things you don't want to do that are horrible - you know, selling my body, stealing from my mom, sleeping in my car," Ohlman says. "How could I not be suicidal?" Read more here.

The Evolution Of Successful Value-Based Contracting

It's always interesting to "kick the tires" on a value-based contracting model that is up and running-and working. Our team had that opportunity at The 2018 OPEN MINDS Performance Management Institute in the session, How To Develop A Value Based Reimbursement Agreement: The Centerstone/Passport Health Case Study, featuring Liz McKune, Vice President, Health Integration at Passport Health Plan and Kelley Gannon, Chief Operating Officer, and Debbie Cagle-Wells, Chief Marketing Officer at Centerstone.

In their presentation, they discussed two separate shared savings incentive programs that started in June 2017. One is based on a population management incentive that is looking at the health of the membership that receive services from Centerstone. In this model, Dr. McKune discussed the process of establishing several baseline clinical measures, with incentive payments tied to reduction in medical hospitalization, emergency department utilization, and reduction in inpatient behavioral health stays. Under this model, savings are shared if there is a reduction in spending in those three areas and if quality metrics are achieved, such as improvements in follow-up after hospitalization for mental illness; documentation of body mass index (BMI) with a plan to address BMI; tobacco use screening and cessation; and communication with primary care providers and referring providers at the initiation and discontinuation of treatment.

The other shared savings program-for individuals with serious mental illnesses-is in the pilot stage and is focused on savings related to reduced medical inpatient stays, reduced emergency department utilization, and reduced behavioral health inpatient stays. Read more here.