Literature Collection

1221

Trends of Cocaine Use and Manifestations in Hospitalized Patients: A Cross-Sectional Study

Type: Journal Article

Authors: K. Gangu, A. Bobba, S. D. Basida, S. Avula, H. Chela, S. Singh

Year: 2022

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1222

Triple Aim: Benefits of behavioral health providers in primary care

Type: Journal Article

Authors: H. Reppeto, C. Tuning, D. H. Olsen, A. Mullane, C. Smith

Year: 2021

Abstract:

There is little research on behavioral health consultants addressing The Triple Aim goals in a community setting. This study examined the behavioral health consultants' effect on (1) reducing overall patient cost and (2) improving population health by examining psychological screening measures, healthcare utilization, and hospital charges. Results revealed changes in patient charges: emergency department encounters reduce by 8 percent, psychological distress significantly decrease (Patient Health Questionnaire-9, 13.9 to 10.9, p < 0.001; Generalized Anxiety Disorder-7, 12.2 to 9.8, p < 0.001), and reduction in suicidal ideation (p < 0.001) following behavioral health consultant contact. Findings suggest that utilization of behavioral health consultants help health care systems meet The Triple Aim goals.

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1223

Two-minute mental health care for elderly patients: Inside primary care visits

Type: Journal Article

Authors: Ming Tai-Seale, Thomas McGuire, Christopher Colenda, David Rosen, Mary Ann Cook

Year: 2007

Publication Place: United Kingdom: Wiley-Blackwell Publishing Ltd.

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1224

Two-Thirds Of Primary Care Physicians Accepted New Medicaid Patients In 2011-12: A Baseline To Measure Future Acceptance Rates

Type: Journal Article

Authors: S. L. Decker

Year: 2013

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1225

Types of Utilization and Types of Treatment Response in a Collaborative Care Approach for Depressive Disorders in Old Age in Primary Care

Type: Journal Article

Authors: T. Kloppe, N. J. Pohontsch, M. Scherer

Year: 2020

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1226

UNC Health Systems and Blue Cross and Blue Shield of North Carolina patient-centered medical home collaborative

Type: Journal Article

Authors: D. Bradley, D. R. Rubinow

Year: 2011

Publication Place: United States

Abstract: UNC Health Systems and Blue Cross and Blue Shield of North Carolina have entered into a joint venture that is designed to improve patient outcomes and experience and to control medical costs for patients with chronic conditions. This commentary reviews the impetus for, and the anticipated outcomes of, the model practice.

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1227

Understanding Parity: A Guide to Resources for Families and Caregivers

Type: Web Resource

Authors: Substance Abuse and Mental Health Services Administration

Year: 2022

Publication Place: Rockville, MD

Topic(s):

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Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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1228

Understanding the behavioral healthcare crisis: The promise of integrated care and diagnostic reform

Type: Book

Authors: Nicholas A. Cummings, William T. O'Donohue

Year: 2011

Publication Place: New York

Abstract: Where we are, how we got there, and where we need to go: the promise of integrated care / Nicholas A. Cummings and William T. O'Donohue -- Our 50-minute hour in the nanosecond era. The need for a third "e" in behavioral healthcare: efficiency / Nicholas A. Cummings -- The financial dimension of integrated behavioral/primary care / Nicholas A. Cummings, William T. O'Donohue, and Janet L. Cummings -- Mental health informatics / Bruce Lubotsky Levin and Ardis Hanson -- E-health and telehealth / Anthony Papa and Crissa Draper -- Can prescribing psychologists assist in providing more cost-effective, quality mental healthcare? / Morgan T. Sammons -- Diagnostic system innovations / Thomas A. Widiger -- Evidence-based treatment / E. David Klonsky -- The quality improvement agenda in behavioral healthcare reform: using science to reduce error / William O'Donohue, Rachel Ammirati, and Scott O. Lilienfeld -- The behavioral health medical home / Dennis Freeman -- Reforms in professional education / Ronald R. O'Donnell -- Pay for performance and other innovations in reimbursement for behavioral care services / Nicholas A. Cummings and Janet L. Cummings -- Trends in behavioral healthcare for an aging America / Christina Garrison-Diehn ... [et al.] -- Failure to serve: the use of medications as a first-line treatment and misuse in behavioral interventions / John L. Caccavale with the collaboration of Joseph Casciani ... [et al.] -- Reforms in treating children and families / James H. Bray -- Reforms for ethnic minorities and women / Lorraine Benuto and Brian D. Leany -- Wellness and prevention: key elements in the next generation of behavioral health service delivery systems / Monica E. Oss -- Reforms in veteran and military behavioral health / R. Blake Chaffee -- Biofeedback / James Lawrence Thomas.; "The Promise of Integrated Healthcare is a necessary book, edited and contributed to by a great variety of authors from academia, government, and industry. The book takes a bold look at what reforms are needed in healthcare and provides reforms and specific recommendations. Some of the serious concerns about the healthcare system that Cummings, O'Donohue, and contributors address include access problems, safety problems, costs problems, the uninsured, and problems with efficacy. When students, practitioners, researchers, and policy makers finish reading this book they will have not just a greater idea of what problems still exist in healthcare, but, more importantly, a clearer idea of how to tackle them and provide much-needed reform"--

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Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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1229

Uptake of Medicare Behavioral Health Integration Billing Codes in 2017 and 2018

Type: Journal Article

Authors: J. D. Brown, C. Urato, P. Ogbuefi

Year: 2021

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1230

Use of behavioral health care in Medicaid managed care carve-out versus carve-in arrangements

Type: Journal Article

Authors: C. J. Charlesworth, J. M. Zhu, M. Horvitz-Lennon, K. J. McConnell

Year: 2021

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1231

Use of buprenorphine for those with employer-sponsored insurance during the initial phase of the COVID-19 pandemic

Type: Journal Article

Authors: J. Cantor, A. W. Dick, R. Haffajee, M. F. Pera, D. M. Bravata, B. D. Stein, C. M. Whaley

Year: 2021

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1232

Use of depression education materials to improve treatment compliance of primary care patients

Type: Journal Article

Authors: Francisca Azocar, Robert Branstrom

Year: 2006

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1233

Use of health care resources and loss of productivity in patients with depressive disorders seen in Primary Care: INTERDEP Study

Type: Journal Article

Authors: F. Caballero-Martinez, F. Leon-Vazquez, A. Paya-Pardo, A. Diaz-Holgado

Year: 2014

Publication Place: Spain

Abstract: INTRODUCTION: The InterDep Study analyzes the characteristics of patients with a depressive disorder who, in the last years, have received health services at Primary Care in an specific health care area. The InterDep Study evaluates the use of heath care resources attributable to depression (direct costs) and loss of productivity (indirect costs). It also analyzes these patients' referral to the specialist. METHODS: A retrospective, multicenter observational study was conducted using computerized medical records collected in an anonymized database of 22,795 patients who received health care services between 2005 and 2009 for a new episode of depressive disorder in a specific Primary Care Area of the Madrid Health Service (Community of Madrid) (former Area 6). RESULTS: A 74.5% of the patients with depressive disorders were women, mean age 54 years (SD 17.7). According to the ICPC classification, depression was the most frequently diagnosed disorder (48.4%), followed by anxiety (35.4%) and adjustment disorder (16.2%). A 88.5% were treated with selective serotonin reuptake inhibitors (SSRIs) (N06AB). The average total annual cost (both direct and indirect costs) was 725.2 Euros. Loss of productivity was the major cost in depressed patients treated in primary care (501.0 Euros), especially among those patients on disability. A 29.7% of the patients were referred to specialized care. CONCLUSIONS: The prevalence and the socio-sanitary impact of depressive disorders in primary care require adequate clinical competence from the physician to guarantee proper disease management thus, minimizing the significant direct (health care resources) and indirect (loss of productivity) cost.

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1234

Use of in-network insurance benefits is critical for improving retention in telehealth-based buprenorphine treatment

Type: Journal Article

Authors: A. R. Williams, C. Rowe, L. Minarik, Z. Gray, S. M. Murphy, H. A. Pincus

Year: 2024

Abstract:

An empiric evidence base is lacking regarding the relationship between insurance status, payment source, and outcomes among patients with opioid use disorder (OUD) on telehealth platforms. Such information gaps may lead to unintended impacts of policy changes. Following the phase-out of the COVID-19 Public Health Emergency, states were allowed to redetermine Medicaid eligibility and disenroll individuals. Yet, financial barriers remain a common and significant hurdle for patients with OUD and are associated with worse outcomes. We studied 3842 patients entering care in 2022 at Ophelia Health, one of the nation's largest OUD telehealth companies, to assess associations between insurance status and 6-month retention. In multivariable analyses, in-network patients who could use insurance benefits were more likely to be retained compared with cash-pay patients (adjusted risk ratio [aRR]: 1.50; 95% CI: 1.40-1.62; P < .001). Among a subsample of 882 patients for whom more detailed insurance data were available (due to phased-in electronic health record updates), in-network patients were also more likely to be retained at 6 months compared with insured, yet out-of-network patients (aRR: 1.86; 95% CI: 1.54-2.23; P < .001). Findings show that insurance status, and specifically the use of in-network benefits, is associated with superior retention and suggest that Medicaid disenrollment and insurance plan hesitation to engage with telehealth providers may undermine the nation's response to the opioid crisis.

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1235

Use of opioid substitution therapies in the treatment of opioid use disorder: results of a UK cost-effectiveness modelling study

Type: Journal Article

Authors: J. Kenworthy, Y. Yi, A. Wright, J. Brown, Maria Madrigal, W. C. N. Dunlop

Year: 2017

Publication Place: England

Abstract: AIMS: This study investigated the cost-effectiveness of buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT) vs no opioid substitution therapy (OST) for the treatment of opioid use disorder, from the UK National Health Service (NHS)/personal social services (PSS) and societal perspectives over 1 year. METHODS: Cost-effectiveness of OST vs no OST was evaluated by first replicating and then expanding an existing UK health technology assessment model. The expanded model included the impact of OST on infection rates of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection. RESULTS: Versus no OST, incremental cost-effectiveness ratios (ICERs) for BMT and MMT were pound13,923 and pound14,206 per quality-adjusted life year (QALY), respectively, from a NHS/PSS perspective. When total costs (NHS/PSS and societal) are considered, there are substantial savings associated with adopting OST; these savings are in excess of pound14,032 for BMT vs no OST and pound17,174 for MMT vs no OST over 1 year. This is primarily driven by a reduction in victim costs. OST treatment also impacted other aspects of criminality and healthcare resource use. LIMITATIONS: The model's 1-year timeframe means long-term costs and benefits, and the influence of changes over time are not captured. CONCLUSIONS: OST can be considered cost-effective vs no OST from the UK NHS/PSS perspective, with a cost per QALY well below the UK's willingness-to-pay threshold. There were only small differences between BMT and MMT. The availability of two or more cost-effective options is beneficial to retaining patients in OST programs. From a societal perspective, OST is estimated to save over pound14,032 and pound17,174 per year for BMT and MMT vs no OST, respectively, due to savings in victim costs. Further work is required to fully quantify the clinical and health economic impacts of different OST formulations and their societal impact over the long-term.

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1236

Use of tele–mental health in conjunction with in-person care: A qualitative exploration of implementation models

Type: Journal Article

Authors: Lori Uscher-Pines, Pushpa Raja, Nabeel Qureshi, Haiden A. Huskamp, Alisa B. Busch, Ateev Mehrotra

Year: 2020

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1237

Using choice architecture to integrate substance use services with primary care: Commentary on Donohue et al

Type: Journal Article

Authors: Leo Beletsky

Year: 2018

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1238

Using financial incentives to promote shared mental health care

Type: Journal Article

Authors: C. S. Dewa, J. S. Hoch, P. Goering

Year: 2001

Publication Place: Canada

Abstract: OBJECTIVES: To consider the most common primary care reimbursement structures, to identify incentives inherent in each, and to discuss how each could be used to encourage a shared-care approach to treating mental disorders at the primary care level. METHOD: Three major financial reimbursement models--fee-for-service, capitation, and blended payment mechanisms--are examined. Each is considered in terms of its risk-sharing elements and the consequent incentives. We offer several scenarios to illustrate how the shared-care practice model might be encouraged under each financing mechanism. RESULTS: The current fee-for-service system does not encourage shared care. For wide adoption of the shared-care practice model, there must be a change in the reimbursement system's incentives. While none of the financing mechanisms offers a perfect solution, each has potential. Each, however, must be carefully tailored to its environment. CONCLUSIONS: Financial considerations are just one aspect to achieving shared care. Nevertheless, in designing a system to encourage collaborative, coordinated care for those suffering from mental illness, decision makers should be wary of creating or maintaining obstacles (financial or otherwise) to provision of accessible, high-quality care.

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1239

Using nurse practitioners to implement an intervention in primary care for high-utilizing patients with medically unexplained symptoms

Type: Journal Article

Authors: J. S. Lyles, A. Hodges, C. Collins, C. Lein, C. W. Given, B. Given, D. D'Mello, G. G. Osborn, J. Goddeeris, J. C. Gardiner, R. C. Smith

Year: 2003

Publication Place: United States

Abstract: Patients with medically unexplained symptoms (MUS) often are a source of frustration for clinicians, and despite high quality biomedical attention and frequent diagnostic tests, they have poor health outcomes. Following upon progress in depression treatment approaches, we developed a multidimensional treatment protocol for deployment by primary care personnel. This multi-faceted intervention for MUS patients emphasized cognitive-behavioral principles, the provider-patient relationship, pharmacological management, and treating comorbid medical diseases. We deployed it in an HMO using nurse practitioners (NP) to deliver the intervention to 101 patients, while 102 controls continued to receive medical care from their usual primary care physician. Successful deployment of the intervention required training the NPs, continuing support for the NPs in their management of this difficult population, and establishing strong communication links with the HMO. This paper addresses the practical considerations of using primary care personnel to implement a complex intervention in primary care, and it includes a discussion of special challenges encountered as well as solutions developed to overcome them.

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1240

Using Payment Policies to Support Primary Care - Behavioral Health Integration in Medicaid

Type: Report

Authors: S. Regmi, A. Snyder

Year: 2014

Topic(s):

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Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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