Advice On Integration – From 40 Years Of Doing It
By Monica E. Oss, CEO, Open Minds
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Developed by OPEN MINDS, 163 York Street, Gettysburg PA 17325, .Ìý All rights reserved
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Greetings from New Orleans, where this morning we kicked off theÌý! Today’s exciting agenda started with Dr. Dennis Freeman, Chief Executive Officer of Cherokee Health Systems, delivering the keynote address –ÌýÌýpremium members.
There was one key element of Dr. Freeman’s presentation that has stuck with me in particular – integrated models are not “primary care + behavioral health.” The integrated model that seems to stand the test of time (both financially and clinically) is behaviorally-led primary care. And, in this model, the “behavioral health” element is not behavioral health illnesses but health-related behavior management (more on that a little later this week).
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Dr. Freeman expressed his concern about the financially stability of many of the emerging integrated services delivery models. A concern that is based on five common situations in these emerging models:
- Retaining a “specialty” mind-set when a more generalist vision is needed
- Using the old staffing and administrative models when a new organization is needed
- Recruiting primary care providers during a primary care provider shortage
- Relying on grant support instead of sustainable funding
- Failing to recognize and adapt to primary care as a volume-driven business
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His advice – based on 40 years of experience – for the organizations that are developing an integrated service delivery model?
- Patients always point the wayÌý– Primary care is the portal into the health care system, and the system needs to change – not the patients.
- Mission is the compassÌý– An organization can’t be integrated if it doesn’t truly want to be integrated.
- Developing the care model takes workÌý– Just showing up (or saying you are developing an integrated model) is not enough.
- Bring valueÌý– The importance of this is twofold: Always be able to demonstrate your financial value, but also, always strive to serve the greater good.
- Friends in high places can be helpful, though not essentialÌý– No organization is an island, and asking for and receiving help can be very important. But even if you don’t have that support, success is still possible.
- Payment methodologyÌý– Don’t forget that payment is not the vehicle – it is the fuel.
- Contracting is a high stakes gameÌý– Payment may be merely the fuel, but fuel is necessary. Know your contracts because your contracts ARE your reality.
- Not every behaviorist can make it in primary careÌý– At the end of the day, not every organization can make it in a primary care setting, and it will take a level of planning and wisdom to recognize which ones can and can’t.
- Just do itÌý– Eventually the planning must stop, and implementation must begin.
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Tomorrow kicks off day two of this year’sÌýÌý– our deep dive into health homes from state mental health directors and CMHC executives who are “just doing it.” If you couldn’t join us here in New Orleans, follow our live updates on TwitterÌý.
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