GrantWatch Blog invited the author, who recently joined the staff of the Foundation for a Healthy Kentucky, to report on its recent Howard L. Bost Memorial Health Policy Forum, which was held in Lexington.
On September 17, the Foundation for a Healthy Kentucky held its tenth annual health policy forum in Lexington, Kentucky. (The forum was named the Howard L. Bost Memorial Health Policy Forum several years ago.) This year’s event was titled “No Wrong Door: Integrating Care for Better Health.” The forum addressed economic and human effects of providing medical and behavioral health services in a more seamless and systematic way. (The term “behavioral health” used here includes mental health and substance use services.) This year’s forum attracted more than 300 diverse community leaders, advocates, and health providers from around the state.
The day started with remarks by Kentucky’s secretary of health and family services, Audrey Tayse Haynes. Referencing the extensive evidence supporting integrated care, Haynes stated, “The jury is not out on the benefits of care integration.” She spoke of efforts by the State of Kentucky to integrate care and reiterated Kentucky’s commitment to having Kentucky Medicaid managed care integrate behavioral and physical health for those most vulnerable.
Renee Shaw of Kentucky Educational Television shared an excerpt from its soon-to-be-released No Health without Mental Health, a new hour-long documentary and studio health program in the station’s Health Three60 series, which is funded in part by the Foundation for a Healthy Kentucky.
Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, moderated the morning plenary panel, which included Joan Kenerson King of the National Council for Community Behavioral Healthcare; Steve Melek of Milliman actuaries; Todd Prewitt of Humana, the insurer; and Ben Miller of the Office of Integrated Healthcare Research and Policy at the University of Colorado, Denver. The panel addressed both the complexity and the potential of fully integrated care.
King used patient experiences to share a vision for integrated care: all services provided in one place, with the health and social needs of a person and his or her family being seamlessly addressed. The current “sick care” system burdens the patient and family with the complexities of coordinating care among various providers—this is a difficult process in which missed opportunities can endanger patients—for example, missing potentially dangerous drug interactions or being unaware of social barriers to adhering to treatments.
Melek presented data on the costs to employers when persons with chronic conditions experience an untreated comorbidity in mental health or substance use and the savings gained by also addressing these needs.
Prewitt, a physician, reminded us that “all health care ends up being local.” He described Humana’s integrated care programs that have engaged consumers and have shown cost savings and better health outcomes.
Miller called on attendees to remember that multilevel problems need multilevel solutions. Currently, we train and give health providers incentives to provide fragmented care, and the community expects fragmented care. Miller challenged us to change the way we imagine care. To do this, we need to create a common language in integrated care and learn more about what works. In integrated care, “it’s not about you; it’s about we.” His call to action was the following: “Be compelling, be accurate, be timely,” pursue the Triple Aim, and “keep disrupting, keep innovating.”
The luncheon speaker, Mary Takach of the National Academy for State Health Policy, spoke about states’ experiences with integrated care and its future. When the U.S. health care system is compared with the systems in other countries, the U.S. system ranks last in quality, last in access, and highest in cost, with a high number of preventable deaths compared with rankings for other countries. Understanding that this is not sustainable or functional and that we must improve access to care and quality of care and contain costs, she called for “payment and delivery system reform.” Takach identified the patient-centered medical home model and the Medicaid health home model in the Affordable Care Act (ACA), as tools to move from a volume-based system to a value-based system. Read the rest of this entry »