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Medicaid Matters: Depression and other Psychiatric Illnesses

Medicaid Matters: Depression and other Psychiatric Illnesses. Jorge Cortina, MD DFAPA West Virginia Medicaid Behavioral Health Medical Director for UniCare an Anthem Company. Cost of Chronic Mental Illnesses.

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Medicaid Matters: Depression and other Psychiatric Illnesses

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  1. Medicaid Matters:Depression and other Psychiatric Illnesses Jorge Cortina, MD DFAPA West Virginia Medicaid Behavioral Health Medical Director for UniCare an Anthem Company

  2. Cost of Chronic Mental Illnesses • Chapel. Prevalence and Medical Costs of Chronic Diseases Among Adult Medicaid Beneficiaries (2017) • https://www.hcup-us.ahrq.gov/reports/factsandfigures/2009/pdfs/FF_report_2009.pdf retrieved 8/27/18 • http://www.mentalhealthamerica.net/issues/2017-state-mental-health-america-ranking-states retrieved 8/27/18 • https://www.nami.org/learn-more/mental-health-by-the-numbers retrieved 8/27/18

  3. Mental Health of West Virginians • WV highest rates of Opioid Used Disorder and complications • (NAS, infections and overdose) • 2nd highest rate of depression (nearly 1 in 4) • Most common in middle aged low income • 2nd highest ratesof smoking(25%) • 11th highest rateof mental illnessor substance abuse • http://www.wvdhhr.org/bph/hsc/pubs/brfss/2016/BRFSS2016.pdf retrieved 8/27/18 • http://www.mentalhealthamerica.net/issues/2017-state-mental-health-america-ranking-states retrieved 8/27/19

  4. Interaction between chronic physical and mental conditions and Social Determinants of Health • Physical illness and conditions such as diabetes, heart disease, COPD increase the risk of depression and depression hinders good self care • Those with Psychiatric and Substance Use Disorders • Higher prevalence of medical illnesses such as COPD, heart disease and diabetes • Less likely to get their conditions diagnosed and treated • More likely to be impoverished, malnourished, homeless, exposed to unhealthy environments • Alexandria, VA: Parks, J., et al. Morbidity and Mortality in People with Serious Mental Illness (2006)

  5. Bill 48

  6. Mary 56

  7. Two Major Challenges (and Opportunities)

  8. Integrated Care for Physical and Behavioral Disorders Levels of integration 1 2 3 • Coordination • (different settings occasionally sharing information and plans) • Colocation • (greater opportunity for coordination and collaboration) • Integration • (merged, collaborative, single record, strong relationships, frequent contact and informal consultation) • https://www.integration.samhsa.gov/about-us/CIHS_Integration_101_FINAL.pdf retrieved 8/27/18

  9. Healthy People 2020Examples of Social Determinants of Health • https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health

  10. Successful Disease Management • https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/how-to-design-a-successful-disease-management-program retrieved 8/27/18

  11. Medicaid Initiatives to address SDOH and Promote Integrated Care

  12. Questions?

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