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Mental Health System Transformation

Federal changes to health careRecession Growth of covered populations (Medicaid and private)State Budget crisis - $10 billion dollar gapStructural changes and system restructuringWhat does it all mean?. Impact of Change on Mental health Services. Significant changes for mental healthHealth ex

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Mental Health System Transformation

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    1. Mental Health System Transformation Gary Weiskopf New York State Office of Mental Health

    2. Federal changes to health care Recession Growth of covered populations (Medicaid and private) State Budget crisis - $10 billion dollar gap Structural changes and system restructuring What does it all mean? Impact of Change on Mental health Services

    3. Significant changes for mental health Health exchange by 2014 Growth of private coverage Parity – affects – commercial and self insured payers Medicare copays increasing to 80% Focus on managing chronic illness Federal health reform

    4. Budget deficit Changes to the Medicaid program Controls on Medicaid spending Medicaid as Insurance package not funder Additional systems controls Reductions in local assistance Expansion of Medicaid/FHP/CHP populations Focus on behavioral health populations Changes to the mental health service system Clinics, CDT, inpatient, others. State reform

    9. Structural Changes Managed Care – Behavioral Health Organization Manages Medicaid mental health services and integrates care with physical health utilizing health homes and other means Facilitates system integration and reduces over-utilization of costly hospital, ER and criminal justice services. Establishes and monitors quality measures. Facilitates early engagement of high acuity, disconnected individuals. Mental Health “health homes” Health homes have three general requirements including: Facilitates access to an inter-disciplinary array of medical care, behavioral health care, and community-based social services and supports for both children and adults with chronic conditions. Incorporating a “whole-person” philosophy – An individual’s physical condition plus links to long-term community care services and supports, social services, and family services. 3/31/2012 9

    10. Money is scarce – no surprise Behavioral health providers need to operate very efficiently Shared back off-space Streamline record keeping - NYSCRI Extended hours to meet people’s needs Better integration and service coordination Health Homes Coordinated IT - Tie into RHIOs in area Example: Long Island group project Show outcomes! Reduced hospitalizations and management of high needs patients Link to discharges Watch medication usage Focus on medical needs. What does this all mean?

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