Coordination of Care

1. Coordination of Care Information for Network Providers

2. The Value of Coordinated Care • Sharing treatment information among health care providers supports greater safety and improved outcomes for consumers • Achievements in Clinical Excellence program rewards improved outcomes • Coordination of care takes on greater importance for those with severe and persistent mental health and/or substance use disorders • Effective coordination of care can lead to improved health outcomes • Completion of Wellness Assessments can assist in management of total member health options • Improved outcomes frequently result in reduced healthcare costs

3. Why is Coordination of Care Important? Life Expectancy • Individuals who are treated for serious mental illnesses in public mental health systems die 25 years earlier on average than members of the general population • About 60% of these premature deaths are from treatable medical conditions such as cardiovascular and pulmonary disease, diabetes, respiratory and infectious diseases • Individuals with mental illness also have higher rates of smoking, alcohol and drug use, poor nutrition, obesity and unsafe sexual behavior

4. Why is Coordination of Care Important? (Continued) Medications • Coordination of care is especially important when medications are prescribed, when there are co-existing medical/psychiatric conditions, and whenever clients are hospitalized with co-existing conditions • Communication between treating practitioners can minimize the risk of adverse medication interactions for clients being prescribed psychotropic medications • Coordination of care can help to reduce the risk of relapse for clients with substance abuse disorders or psychiatric conditions

5. Is Coordination of Care Necessary? A Case for Care Coordination • Depression can impair a person’s efforts to provide self-care and interrupt adherence to treatments for co-occurring chronic illness • Poor attention to prevention and treatment of chronic medical conditions can contribute to premature cardiovascular deaths • NIMH-sponsored report which studied adults with depression and diabetes or cardiovascular disease identified that when coordination of care between mental health and physical health care providers occurred, those clients showed greater improvements in their depressive and medical symptoms than those where the care was not coordinated

6. When should Coordination of Care occur? • Built in to your practice philosophy, coordination can enhance treatment continuity across all levels of care and between behavioral and medical treatment modalities • Upon initiation of treatment, gather the appropriate and necessary information to coordinate care with other treating professionals, especially when serious medical conditions are disclosed • During treatment, coordinate care periodically, paying particular attention when a medication is initiated, is discontinued or is changed, or when a member’s condition has altered • When a client is discharged, transferred, or referred to another or different treating professional

7. Tips for Accomplishing Coordination of Care • Engage your client during the initial session about the importance of your interaction with his/her other treating clinicians, including physical health practitioners • Document this interaction in the member’s chart, including notations if the individual does not have a Primary Care Physician (PCP) or refuses to allow contact with other clinicians • Within a week of initial assessment, provide other treatment professionals* with the following: • Brief summary of patient’s assessment and treatment plan recommendations • Diagnosis • Medications prescribed including dosages • Your name, contact information, and the best time to reach you *Please have appropriate permissions/releases on file

8. Tips (Continued) • Request that the provider with whom you are coordinating care supply all relevant clinical information they have pertaining to: • Medical condition • Mental health condition • Substance use • Document these actions in the progress notes

9. What’s in Care Coordination for You? • It is good for your clients – it supports quality outcomes • It is good for your practice – it encourages networking • It is the right thing to do and is an expected standard of practice

10. References • Morbidity and Mortality in People with Serious Mental Illness. National Association of State Mental Health Program Directors. Parks, J MD; Svendsen, D MD; Singer, P MD; Foti, ME MD; Mauer, B MSW. October, 2006. Pages 1-87 • President’s New Freedom Commission Report, 2003 Coordinating care is the right thing to do and is an expected standard of practice • Collaboration between primary physicians and behavioral health clinicians makes a difference. UnitedHealthcare Network Bulletin. May, 2012. Page 42 • No health without mental health. NIMH Website http://www.nimh.nih.gov/about/director/2011/no-health-without-mental-health.shtml • Achievements in Clinical Excellence program (Clinicians) https://www.providerexpress.com/content/ope-provexpr/us/en/clinical-resources/aceClins.html.html

11. Thank You.