Behavioral health patients have higher-than-average rates of emergency department visits, hospitalizations, and readmissions. To make behavioral health a core part of its population health strategy, one Ohio health system is partnering with a mental health services provider.
As hospitals and health systems work to develop population health strategies to better serve their communities and rein in the overall cost of care, behavioral health patients—who have higher-than-average rates of emergency department visits, hospitalizations, and readmissions—cannot be ignored.
Lee Hammerling, MD
These individuals make up a large subset of the patient population. According to the Substance Abuse and Mental Health Services Administration's 2012 National Survey on Drug Use and Health, 43.7 million (18.6%) U.S. adults experienced some form of mental illness that year. Additionally, 20.7 million adults (8.8%) had a substance use disorder, and of those, 8.4 million people had both a mental disorder and a substance abuse disorder.
"I think behavioral health needs to be a foundational core strategy for any population health program for an integrated delivery system," says Lee Hammerling, MD, chief physician executive and chief medical officer of ProMedica, a Toledo, Ohio-based health system with 2,268 licensed beds and fiscal year 2014 budgeted revenue of $2.6 billion.
"Without it, you will never be as successful as you need to be. Behavioral health is pervasive and impacts so many conditions, like diabetes, cancer, and congestive heart failure, and the increase in ED use and admissions can be as high as 60%."
Behavioral health is part of care coordination
ProMedica's approach begins with in-office screenings for behavioral health issues.
"Our goal is to screen 100% of patients that present in our offices. We have about 1.6 million encounters per year, and we want all of those patients to be screened at least once annually," Hammerling says. "Everybody is being screened for high blood pressure, weight, and BMI. Why wouldn't we also ask them about things like their sleep patterns, depression, and anxiety? It's not isolated. It's part of your overall health."
Once a physician determines that a patient needs additional care to deal with a mental health or substance abuse problem, there needs to be a referral path in place, he says.
Rene Letourneau is a contributing writer at HealthLeaders Media.