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Innovation and integration

Rising tide may lift all boats in accountable care
The benefits of accountable care organizations expand as some providers deliver the same standards of care to all. “Embracing the desire of ACO providers to level-up care to the new standards created for ACO patients may result in immediate spillover effects that improve the quality and affordability of health care for all patients,” researchers conclude. (NEJM Catalyst)

Why providers are turning to clinically integrated networks
Hospitals and independent physicians are improving quality and efficiency by forming clinically integrated networks (CIN). CINs are nimble and optimize processes to provide the best possible care. “They are focused on the use of metrics, structure and processes ingrained in the group’s ethics and ideals to discover the best way to treat and care for patients.” (Becker’s Hospital Review)

CINs on the increase, suggesting more holistic approach to care
As value-based care expands, risk-based population health management arrangements may increase as well. Providers will be rewarded based on the health of the communities they care for. Additionally, clinically integrated network development increased; this may represent a shift away from piecemeal population health programs towards more holistic approaches to care coordination and patient management. (HealthIT Analytics)

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Sharon Raggio, LPC, LMFT, MBA, president and CEO of Mind Springs Health, discusses reconnecting the mind and the body, and the barriers to making that happen.

The research supports connecting the mind and the body, and it just makes sense. So why isn’t it happening yet?

Raggio: There are several things that stand in the way. Certainly in this country, we’ve had a disconnect between the mind and the body for years. It comes down to a trifecta of issues: It’s policy, it’s financing and it’s culture. For example, government programs, much less insurance programs, are not designed to cover the cost of providing both behavioral health and primary care in an integrated fashion. By policy and benefit design, the head has been disconnected from the body fiscally.
Another example is health IT: Health IT has a whole legacy of financial, policy and cultural barriers to more robust sharing. There are so many policies about what you can and cannot share–policies that separate behavioral health from physical health and do not allow anyone to really understand and treat the whole person.

What is the role of health IT?

Raggio: Health IT serves a critical role in sharing information in and among organizations. Without that information, we don’t have a full picture of the patient. Here in Western Colorado we have successfully navigated some of the policy and cultural barriers that have impeded data sharing. For example, at patient discharge, Mind Springs puts medication information into Quality Health Networks (QHN), the local health information exchange, and shares it electronically with the patient’s primary care provider, giving him or her a more comprehensive view of the patient’s medications. We’ve received patient health data from the primary care provider through QHN, but we couldn’t share our medication information with them. It took four years to accomplish a path through the legal and operational barriers; we completed it in April. But we found a way to do it.

Why are you seeing success in re-integrating mind and body?

Raggio: Here in Western Colorado, we’re really leading the change, and we’re doing it together–we’re not having it done to us. Payers, behavioral health providers, primary care–everyone is at the table. We’re really having these conversations together. We talk about benefit design, infrastructure, desired outcomes–and a shared vision. The approach is about inclusivity and shared vision. That’s pretty profound.

There are other factors involved as well. We recognize that our behaviors are the only things we can control that contribute to how healthy we are. We’re seeing more of a focus on connecting head and body–not just in terms of a full-blown mental illness or substance abuse disorder, but in terms of how we can influence behaviors.

I also think there’s a deeper understanding of different payment models–from the state of Colorado, provider and payer perspectives–as a funding mechanism for behavioral health integration.

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Employees need human guidance on plan options
Open enrollment is approaching, and surveys say people still struggle to evaluate their plan options. For example, 69 percent of those surveyed say deciphering jargon is a significant barrier to decision making. Consumers value human help when they first try to understand plan options. After that, interest in digital tools and self-service support grows. (HealthLeaders Media; Alegeus report)

Why do employees decline to participate in workplace wellness?
Nearly 60 percent of employees aren’t participating in workplace wellness programs. The biggest barriers, Employee Benefit News reports, are lack of convenience, a non-supportive company culture, and trust and privacy concerns. It identifies five things every employee wants in a workplace wellness program. (Employee Benefit News
 
Employees: Each year, visit the dentist and check plan options
“One in four people would rather have their teeth cleaned than spend time on open enrollment,” says Rebecca Madsen of UnitedHealthcare. But, like teeth cleaning, exploring the options is the smart thing to do. Employers should encourage workers to review the plan possibilities. The article discusses why. (US News)

Tooresources-iconls and Information

Population health data, trends: The CDC offers a wealth of data through the National Center for Health Statistics: CDC

Benefits trends: The 2016 Aflac WorkForces Report examines benefits trends and attitudes: Aflac

Why a CIN? A two-minute video from Monument Health: Why a Clinically Integrated Network Works for You answers that question: video
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eNewsbrief Archives

January 2017

The First. Achieve. Health. monthly e-newsbrief spotlights the research, trends and people driving positive change in health care delivery. It's…

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November 2016

November 2016

Interview: Michael Thompson, president and CEO, National Alliance and former PwC principal, discusses bending the cost curve, employee engagement and rebooting wellness.
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October 2016

October 2016

Interview: Sharon Raggio, LPC, LMFT, MBA, president and CEO of Mind Springs Health, on reconnecting the mind and the body, and the barriers to making that happen.
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September 2016

September 2016

Interview: Lisa Martin, senior director of human resources at Hilltop Community Resources, on engaging employees and the importance of culture and education.
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August 2016

August 2016

Interview: Monument Health's new CEO, Stephanie Motter, MSN, RN, on her new role, preparation and experience, and the top three goals for the next 12-24 months.
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