NYAPRS Note: The simple article below highlights the central aspects of building an excellent system of care one provider at a time. Moving to an accountable method of treating and referring can be challenging, but ultimately rewarding to a business and the people it serves.
Why Behavioral Health Centers of Excellence?
National Council; Dale Jarvis, 12/17/13
THE FUTURE HAS FINALLY ARRIVED
As health reform kicks into high gear, those Americans with the highest healthcare costs are becoming persons of interest – big time. This is finally getting us to the tipping point we’ve been promoting for many years:
We cannot fix the healthcare system without addressing the needs of Americans with behavioral health disorders due to the high prevalence of behavioral health conditions, the high comorbidity of behavioral health disorders and chronic health conditions, and the high healthcare costs of these individuals.
Health plans, hospitals, primary care providers, and many other groups that are being affected by payment reform and new quality measures are scrambling to hot spot these high cost folks, wrap care around them, and attempt to bend the cost curve, one person at a time.
To hit their quality marks and earn their bonuses, medical homes are attempting to become medical home runs by changing what they do inside their clinics and by taking a new approach to the referrals they make. Previously, many referrals were made based on social networks – who did I go to medical school with or play golf with? This is changing dramatically.
Imagine being a clinician in a medical home, treating a patient who has a serious heart condition or a major mental illness beyond the scope of what you can treat at your clinic. You no longer can afford to make referrals to specialty providers lacking outcomes data or that you know to be poor performers with high error rates, high costs, and poor outcomes. Instead, you must become meticulous about building relationships with high performing specialists to support the whole health of your patients. In other words, you are looking for specialty centers of excellence.
THE IMPLICATIONS FOR BEHAVIORAL HEALTH PROVIDERS
If you are known by the community as a great place to get care and a great place to work, everyone in that community, including the staff working in a medical home, will know that you offer easy access, comprehensive care, excellent (and measurable) outcomes, excellent value, and world class customer service. They will see you as the go-to organization whenever they need help with patients that are experiencing behavioral health issues that go beyond what the clinic can solve. They will call you, you will be there, and you will deliver.
This will also be true with employers, health plans, hospitals, nursing homes, police and fire departments, and neighbors who are trying to figure out how to get world class help for their employees, enrollees, patients, customers, and neighbors.
If you can deliver, everyone wins. If you can’t, we all lose – and they will find someone else who can delivery. I think it’s that simple!
In my next blog post on January 7, I will dig into Element 1: World Class Customer Service Built on a Culture of Staff and Client Engagement and Wellness. Until then, I need some help.
TODAY’S QUESTIONS…
– Tell us what you think.
- – Am I being a Pollyanna or are folks in your community starting to “get it” about the importance of behavioral health?
- – I’ve listed five BHCOE elements: excellent customer service, outcomes, access, comprehensive care and value. What am I missing from the short list?
- – I’ve listed several groups that are dialing into the importance of finding great behavioral health referrals (medical homes, employers, etc.). Who else should be added to the list
- – What else should we be talking about as we wade into the Behavioral Health Center of Excellence conversation?
- Join the conversation at: https://www.thenationalcouncil.org/conference-365/2013/12/17/why-centers-of-excellence/