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A Payer-Guided Approach To Widespread Diffusion Of Behavioral Health Homes In Real-World Settings
James Schuster1, Cara Nikolajski2, Jane Kogan3
1James Schuster is chief medical officer for Medicaid, Special Needs, and Behavioral Services and vice president of behavioral integration, both at UPMC Insurance Services Division, and a senior faculty member at the UPMC Center for High-Value Health Care, all in Pittsburgh, Pennsylvania.
Abstract:
People with serious mental illness experience decreased life expectancy related to co-occurring medical conditions. A nonprofit behavioral health managed care organization implemented an innovative behavioral health home, in partnership with community mental health providers, to build a culture of wellness among all staff members, with a focus on prevention and holistic (that is, behavioral, social, and physical) health. The behavioral health home added one of two distinct care approaches, one patient driven and the other provider driven. The innovative approaches were implemented at eleven community mental health providers: Six delivered patient-driven care, and five delivered provider-driven care. We studied outcomes in the period October 2013-January 2016. Multiple diffusion strategies were utilized to encourage uptake. Our results revealed that both approaches significantly increased patient activation in care (more quickly in provider-supported care), engagement in primary and specialty care, and perceived mental health status. The success of this behavioral health home in improving important outcomes and the use of novel diffusion strategies led to its dissemination to forty-three additional providers across Pennsylvania.
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