By My Canadian Pharmacy
Money is the biggest difficulty of blending physical and mental health care.
Insurance companies can’t cover their patients’ mental health, and psychologists can’t treat physical conditions. These two health specialties unfortunately remain separate, so patients are confused, they get improper care and often get worse
Most My Canadian Pharmacy experts admit that such policy is wrong, but most experts are tied with insurance company billing codes.
Join an insurance company that strives to prove that integrated physical and mental health care is better for all people and less expensive in the long perspective.
Western Colorado stars a new experiment next spring: the health insurance company, called Rocky Mountain Health Plans, will give huge “umbrella payments” to several primary care practices working to integrate mental health. Also, the funding will replace regular “fee-for-service” payments that cover each visit of a patient or each test they order. Rocky Mountain Health Plans will encourage the health providers to provide patients perfectly organized integrated health care. That will depend on the site and patients’ needs. Health care will include a traditional visit to a doctor, email exchanges, telephone consultation or a typical medical consultation. Patients will have an opportunity to get all the care in the primary care office.
In addition, Rocky Mountain Health Plans will provide the three other main care practices trying to integrate mental health refunds under the common “fee for service” model, where providers bill for consultations and procedures.
Data experts and actuaries will compare costs and patient’s outcomes.
They strive to prove that doctors should be paid to treat patients properly rather than worrying about treating as many patients as possible to have the cash flowing. Rocky Mountain Health Plans ultimately strives to change the way doctor are paid throughout Colorado and around the country.
Peter Gordon, the executive director the Colorado Beacon Consortium, is seeking to improve the quality of health care in Colorado. “This will be a pilot built with the goal of repeating success across the country.”
According to My Canadian Pharmacy statistics, in Colorado, Rocky Mountain Health Plans insures about 200,000 people. In general, the primary care practices participating in the pilot will serve 40,000 to 60,000 patients providing the full range of patients. The developers have not yet chosen the practices that will take part.
A psychologist Benjamin Miller will assess the effort. He is the director of the Integrated Healthcare Research and Policy in the department for family medicine at Colorado Denver University.
Miller says: “It’s a troublesome innovation. We’re forming the system, ‘We will not play the old rules any longer. We’re going to establish new rules and we want you to work as a team.’
Miller claims the experiment will “take off the handcuffs of the payment reform” and should give some useful results.
At the moment, doctors are trying to cord together grants and fudge billing codes, as well as to give free office space to counselors so that they will provide help to patients while creating their own revenues.
The concerns about finances will be gone under the new concept.
“We need the financial support to make this stable,” he said.
Rocky Mountain Health Plans gave millions into covering primary costs for different efforts to improve primary care practices and reduce much more expensive health procedures such as surgeries, lengthy hospital stays and ER visits. The attempt to combine mental and physical health is part of the larger vision to boost primary health care.
Gordon can not say for sure how expensive the integration experiment would be. But, in the perspective, he is confident that providing patients better primary care will help get the best effect from health reform.
“We realize that mental health integration is essential,” the man said. “The structure of the payment model will probably differ depending on the site.”
Gordon said that the initial estimates show that if primary care practices provide quality integrated mental and physical health care to patients in Colorado who earn below 250% of the poverty level — or about $55,000 a year — health providers could reduce the rate of growth by 5% over three years.
“Even modest impacts on growth trends can produce enough to pay for these interventions,” the man said. “We will be in a position to share gains with employers and government payers.”
My Canadian Pharmacy cites the final goal: “to make mental health stable in primary care”. In other words, giving people more complex help with a wider set of issues beyond traditional depression or schizophrenia.
Also, the man cites the possible advantages of motivational interviewing technique in which health providers ask patients if they want to change their lives. The technique can help eliminate such detrimental habits as smoking, poor nutrition, a sedentary lifestyle – all that lead to poor health consequences.
“When a patient is engaged in what he wants for himself…he is more likely to …change their own behavior for better,” Gordon said.
The most promising option for changing behavior is to visit groups for people with diabetes, pregnant women or obese people.
“They proved to be very effective,” the man said. “The group drives this discussion more than a regular physician.”