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Outcomes in Integrated Care

Outcomes in Integrated Care. Aileen Wehren April 2012. Types of Outcomes. Process Outcomes Health Outcomes Financial Outcomes Satisfaction Outcomes. Why Measure Outcomes?. Monitor/improve health care quality Provide information about what works and what does not

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Outcomes in Integrated Care

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  1. Outcomes in Integrated Care Aileen Wehren April 2012

  2. Types of Outcomes • Process Outcomes • Health Outcomes • Financial Outcomes • Satisfaction Outcomes

  3. Why Measure Outcomes? • Monitor/improve health care quality • Provide information about what works and what does not • Establish your value as a provider • Provide incentives to providers • Establish accountability

  4. Process Outcomes • Providers are most familiar with these • The most frequent starting place • Examples in medical, dental, behavioral health?

  5. Health Outcomes Selection of Measures • Can you collect the information? • Can you use the information (is it retrievable for care)? • Is the information useful for care, for communication, strategically (internal and external)? • Does the measure fit the population? • Should you look at risk factors, illness (diagnosis), medication, age? • What is the cost?

  6. Selection of Common Measures for Behavioral Health • For depression: PHQ9 • For addictions risk: Audit, CAGE, CRAFFT • For Anxiety: GAD • Functional Health & Well-Being: Short Form 12 or 36 • For Tobacco: Surgeon General Questions, Fagerstrom • For Lifestyle/Diet: Glasgow 2005 • Do you screen (collect data) on everyone? • How often do you screen? • Can you get paid? • Operational impact?

  7. Selection of Medical Outcomes Measures • Weight • Body Mass Index (BMI) • Blood Pressure • Hemoglobin A1c • Triglycerides • Cholesterol • Look at Health Effectiveness Data and Information Set (HEDIS), National Quality Forum (NQF) lists

  8. Selection of Dental Outcomes Measures • Gingivitis • Periodontal disease

  9. Outcomes Measures - Financial • Per member per month cost pre and post • Changes in cost based on length of time in integrated care, presence/complexity of the chronic health conditions • Look at primary care, inpatient (psychiatric and medical), outpatient, ER, pharmacy at a minimum – expected and actual cost trajectories

  10. Outcomes Measures: Satisfaction • Many options

  11. Other Considerations • When do you build in? • Is anyone asking now? • Do you want to be ahead of the curve? • Any questions?

  12. Resources • www.integration.samhsa.gov • www.pcppc.net Patient Centered Primary Care Collaborative • http://www.behavioralhealthintegration.com • National Quality Forum (NQF)

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