Together we share the goal of working efficiently while improving the lives of individuals. White papers are a breadth of resources and educational tools discussing topics and trends. They tackle and dissect tough topics in an effort to further the knowledge within the health and human services communities we serve. Simply click the white paper you’re interested in to register and download the document.
As politicians and legislators discuss and debate the future of healthcare, the facts are that costs are escalating at an alarming rate. Consumers today are faced with less money to spend on their own healthcare needs, and it is becoming more diﬃcult to access care in some areas. Poor coordination of care, especially between primary care providers and behavioral health specialists, causes poor outcomes and increases waste.
Virtual integration through Electronic Health Records (EHRs), Personal Health Records (PHRs) and Health Information Exchanges (HIEs) is more sustainable. The use of these tools ensures that care providers have access to a client’s full medical history, including current medications and health conditions that should be considered as part of diagnosis or treatment, but does not require the attending clinicians to be co-located.
Healthcare integration occurs when healthcare professionals have access to information about – and treat – all health conditions at the same time. This shared accountability leads to improved personal, community and population health outcomes.
Much has been written about primary care integration. The value of integration has been well documented for primary care patients due to the inadequacy of behavioral health services available to them. Likewise, behavioral healthcare consumers often struggle with receiving adequate primary care. Integration has demonstrated clinical and financial advantages over traditional, more siloed models of care. But most methods require physical integration to occur either by placing primary care providers into behavioral health settings or vice versa. While these models have demonstrated efficacy, they will likely need to be supplemented with virtual integration simply because of the logistics and limitations of co-location.
In this whitepaper, a primary care physician and a behavioral healthcare provider/administrator discuss the challenges of integration from the perspective of each clinical discipline. The need for virtual integration models is discussed and suggestions for their adoption are provided. While most integration models propose a dyadic relationship between primary care and behavioral health care providers, this paper posit that integration, especially virtual integration, is a three-way partnership that adds the consumer-directed health model into the mix. This tripartite model is discussed as the future of integration.
When it comes to behavioral health and primary care integration, there are a few things we know:
From these statements it becomes apparent, the goal of integrating primary care and behavioral health is more than breaking down a long-standing gap between two core disciplines of medicine. It is really about addressing the mind/body health needs of an individual, which when united, improve health outcomes.
Accountable Care Organizations (ACOs) are evolving to be a significant option in the ever–changing healthcare landscape. ACOs support the strong trend toward population health and value–based contracting, with a transition to payments based on outcomes rather than services provided … with the goals of improving outcomes and reducing costs.
However, there is one often overlooked or neglected dimension of today’s ACOs: The critical need to incorporate behavioral health quality measures and providers into the mix. As more is known about the need to treat the “whole–person” in healthcare, it becomes increasingly obvious that accountable care without incorporating the clients’ mental and physical health will be very hard—if not unsustainable.
Using an electronic health record (EHR) is the first step to improved health care for your clients. It also allows organizations to provide efficient, coordinated care.
Fast-evolving legislation and standards require that health care organizations provide better care for less cost – and report on outcomes and meet clinical quality measures. As part of this evolution, providers should calculate the cost of non-implementation (or less than optimal implementation) of an EHR. This assessment is critical in deciding if your organization should be in the market for a new EHR and other supporting care coordination solutions. A quality EHR implementation should have concurrent positive impact on the clinical, operational and financial aspects of your agency.
Industry research shows that more than half of all first-time EHR implementations fail. What’s keeping your organization from becoming a statistic?
In this whitepaper, five key values to keep in mind when determining what software solution provider will become your new (next) strategic partner.
Interoperability is one of the most discussed topics in healthcare today. The term typically refers to the architecture or standards that make it possible for diverse electronic health record (EHR) systems to work compatibly. Interoperability is, on the one hand, a technical process and a centerpiece of Stage 2 Meaningful Use (MU) incentive funding. However, when the Office of the National Coordinator for Health Information Technology (ONC) placed improved interoperability front and center in its three-year-agenda this year, it stated its goals are to go beyond physical exchange of data to enable better workflows and reduced ambiguity by providers obtaining and sharing the right information in the right context.
Interoperability between disparate electronic systems plays an important role in breaking down information silos. When effective and meaningful data exchange occurs, the results are improved efficiency, quality, safety and cost of consumer care.
Prepare your organization for the future – today
by Kevin Scalia, Executive Vice President at Netsmart
The Certified Community Behavioral Health Clinic (CCBHC) pilot won’t be concluded until December 2018. But organizations need to start planning now for the impact this model and others like it will have on clinical and operational issues. This whitepaper highlights three areas to start evaluating your organization's ability to make the shift to care coordination and value-based payment models.
Complete the form at the right to read the paper and take the first step to begin planning clinical and operational strategies that will sustain your organization through the changes to come.
As healthcare continues to focus on treating the whole person, the technology to support interoperability will continue to evolve. But organizations whose aim is to integrate all modalities of care need to expand their vision beyond the implementation technology.
AJ Peterson, Netsmart vice president of interoperability, explores how organizations are leveraging technology platforms to improve key processes. He also looks at why putting shared information into context is the key to creating a model for true, collaborative care.
The healthcare landscape is moving at the speed of thought. These are optimistic times for health. The attention and resources being devoted to health are unprecedented. But attention means close scrutiny, and resources come with an expectation of results. The stakes are high and the responsibility to deliver is great.
More than ever, there is a growing understanding of the need to implement a more comprehensive, integrated approach to care that involves caring for the whole person, focusing on optimal healing and wellness, integrating healing practices and holistic systems of medicine informed by evidence and collaborating and coordinating care between providers.
Disruptive technologies and processes will have the biggest impact on healthcare and undoubtedly play a fundamental role in making these aforementioned shifts a reality.
To assist in this endeavor, Netsmart has unveiled the Healthcare IT Value Model geared toward the health and human services provider community. This vendor-agnostic common measurement system can give your organization answers to what you should do next with regards to healthcare IT and the value associated with that strategic decision.
The HIT Value Model is a strategic roadmap embedded in a snapshot of the health and human services care system, with your client (the person) at the center. It offers you a well-defined path for improving financial, clinical and operational performance … the key elements for the long-term sustainability of your organization.
Some $25 billion to $45 billion dollars is lost per year on poor transitions of care, meaning on the failing of the healthcare system to properly transfer a client from the care of one clinician in a certain setting to the care of another clinician in another setting. There are many reasons for this, but most often it happens due to lack of information sharing.
In this new white paper, Netsmart thought leaders look at the powerful impact improved transitions of care can have on individuals with mental illness; as many as 68 percent of adults with mental health conditions also have medical conditions. The improvements include increased client safety, greater efficiency, eliminated redundant or unnecessary testing, better engaged clients, improved public health reporting and monitoring and reduced healthcare costs. There is also an opportunity to reduce hospital readmissions by as much as 30 percent. Netsmart provides best practices and tactics for accomplishing these improved transitions through real examples, happening today, in the healthcare community. They also look at several financial reasons for focusing on improving transitions of care.
The model of the all-knowing clinician and the passive patient is coming to an end, and it’s being replaced by the Recovery Movement. As the mental health community shifts to a more patient-empowered model, clinicians are finding new ways to engage clients to improve service and outcomes.
In this whitepaper, Dennis Morrison, PhD., chief clinical officer at Netsmart, and Roy Starks, M.A., vice president of the Mental Health Center of Denver, explore this shift in priorities. They offer a fascinating look at the benefits of consumer engagement in healthcare, as well as the fine line behavioral healthcare providers must walk between empowering their patients and guiding them through effective treatment plans.
The whitepaper also includes details on the strategies and tactics the Mental Health Center of Denver has successfully employed to increase patient engagement and satisfaction, as well as improve outcomes.
Healthcare has always been a rapidly changing industry. That is more true today than ever before. Here are ﬁve trends that are currently aﬀecting the future of healthcare. Many of these are speciﬁc to behavioral healthcare. All are connected to each other and inﬂuence each other in a variety of ways. They are:
This whitepaper addresses each of these items.
The concept of accountable care has been at the forefront of the health care dialogue. Accountable care forces providers to find new methods of improving client outcomes while lowering costs. We beleive there are three components for achieving accountable care:
This whitepaper tackles accountable care from all three of these angles.
People are constantly comparing themselves with others on the basis of a myriad of factors such as appearance, social status, accomplishments, character traits, and the list goes on. These comparisons probably have their roots in the biological need to establish a “pecking order,” remain “safe within the herd,” and other innate survival-related dynamics. At the very least, people strive to “keep up with the Joneses.” No matter what the origin is, it is what people do. They compare.
The formalized process of drawing comparisons between individuals or entities to identify strengths and opportunities for improvement is known as “benchmarking.” Benchmarking, which taps into this very instinctive need to compare, is an important tool employed in the management of organizations. The purpose of this white paper is to examine benchmarking in behavioral health and human services settings in order to provide the reader with a sound understanding of the rationale, methods, and impact associated with this powerful management tool.
Can scientists identify the root causes of the major psychiatric disorders, such as anorexia nervosa, attention deficit hyperactivity disorder (ADHD), autism, bipolar disorder, major depressive disorder and schizophrenia? The answer to this question is both, “yes” and “no.”
For nearly half-a-century, Netsmart has had the privilege of working with leaders in the health and human services community. It has been a powerful partnership for us thanks to your inspiration and guidance for innovating solutions that help provide consumers with the better lives they yearn for. We have learned a lot over the last 50 years.
Among lessons learned: The body affects the mind and the mind affects the body. For example, people with severe mental illness are likely to die 25 years earlier than those who do not have a mental illness. It’s an alarming statistic that becomes even more startling when you learn that these fatalities occur mainly because of chronic medical conditions (such as obesity, diabetes or infections), most of which can be prevented, treated or managed. These medical illnesses contribute more to premature deaths among people with severe mental illness than suicide.
There is a need for integrated, coordinated, whole-person care.
Individuals are multi-faceted, complex beings that exist within an ecosystem of family, friends, jobs, homes, neighborhoods, geographical areas and psychological and cultural environments, all of which can influence health and disease. For decades, the American healthcare system has elevated measurable, physical aspects of a person. Today, there is a new thrust toward treating the person (not the problem), and toward looking at treatment from the perspective of the whole-person: mind, body and spirit.
Whole-person care incorporates physical health, public health, mental health, addictions treatment and social services, and all of the tools that can be used in these settings to ensure a recovery trajectory.
Using an electronic health record (EHR) is the first step to improved healthcare for your clients. In most cases, it allows organizations to provide efficient, coordinated care. But industry research shows that more than half of all first-time EHR implementations fail. Netsmart leaders provide five things to consider when selecting your new/next EHR … so you don’t become a statistic.
The EHR Is More Than The Automation Of The Paper Chart. It Is A Knowledge Platform. This white paper focuses on the need and best practices for EHRs to be set up not only for cost-benefit success and workflow efficiency, but for their ability to inform and support the clinical process toward improved outcomes. Knowing that better clinical decisions require content that defines data, workflow and decision flow across care processes, this paper will explain how the EHR, configured correctly per care processes and integrated into the workflow, can be transformed from a data-recording repository to a proactive system for knowledge-driven care. It will also offer tips for making this happen.
There’s a change underway in behavioral healthcare. It’s rapid, unprecedented and driven by a combination of factors that includes a focus on clinical quality measures, the integration of behavioral health and primary care, and a shift from treatment-focused care to outcomes and recovery-based care (with a related shift in revenue/reimbursement models). There is significant change and it’s only the beginning.
This transformation has brought increased adoption of electronic health records (EHRs) by behavioral healthcare providers to support integrated clinical data exchange across the care spectrum. But many providers are finding that simply having a functional EHR is not enough; what really matters is using an EHR that enhances quality of care provided to consumers while at the same time increasing business and operational efficiencies.
Up to 80 percent of information in electronic health records (EHRs) is not readily accessible because it's in the form of text or natural language, e.g., notes from physicians, nurses, therapists, admissions, etc. This paper highlights how Mental Health Center of Denver tapped this rich source of
clinical information with innovative technology that expanded the functionality of its EHR.
For years, stakeholders involved in healthcare, including clinicians, staﬀ, clients and their caregivers, and governmental agencies have been in agreement about the need for advancement in technology to help improve client care.
Researchers, practitioners and corporations have made -- and are continuing to make -- eﬀorts to increase the practice of evidence-based medicine through the use of clinical decision support (CDS) systems. In general, these systems are designed to provide clinicians, often at the point of care, with clinical knowledge and client-speciﬁc information to help them make decisions that enhance their clients' care.
There is a compelling need for Clinical Decision Support Systems (CDSS) in electronic health records (EHRs). Not only it is a requirement to achieve Meaningful Use and receive incentives, it is arguably the only way for clinicians of all types to take full advantage of the knowledge available to them. While literature and studies support CDSS, behavioral health care has lagged behind primary care in the use of such systems. The reluctance of behavioral health care to embrace these technologies is due, in part, to the lack of clear standards of care and quantifiable indicators used by behavioral health care providers, whereas medical providers have had a wealth of measurement tools available to them which can be automated into “order sets” and CDSS.
As the health care industry evolves to a pay-for-performance model, we are seeing increased demands for clinical accountability in behavioral healthcare. There is a wealth of data about clinical effectiveness in our industry. Those who have historically tried to oppose these trends on the grounds that behavioral health care is “an art not a science” will fail. These trends will lead to more measurement and more standardization of treatment. Ultimately, they will generate the need for CDSS.
Prescription and over-the-counter medications are milestone medical advances that impact how we treat and prevent illness. Medication therapies for individuals with behavioral health conditions have become much more prevalent and accepted in the past 10 years. Nonetheless, it is primary care physicians that prescribe the majority of behavioral health medications; overall, 67 percent of psychopharmacologic drugs are prescribed by primary care physicians (Rural Health Advisory Committee, 2005). As the healthcare community works toward a more holistic approach to patient care, there will be greater opportunity for treatment optimization but also greater burden on medical professionals to navigate the complexities of medication management.
It is time to redefine the best practice closed-loop medication process and focus on a comprehensive medication management process that spans the continuum of care. This evidence-based, groundbreaking methodology has the potential to bridge the medication management gaps in inpatient and outpatient settings and to ensure clients receive optimal prescriptions and care for both episodic and chronic circumstances.
Polypharmacy is an ever-increasing concern for today’s mental health administrators. The amount of psychiatric polypharmacy has been increasing each year. The main focus of polypharmacy awareness has been related to both clinical concerns – such as patient safety and more effective, evidence-based prescribing – and costs. This whitepaper raises awareness of inappropriate polypharmacy, the use of polypharmacy that goes against good medical evidence and practice. It also provides possible solutions for mental health care providers to manage it.
Many clinicians now believe that there is a direct correlation between substance use and mental illness and that these disorders need to be treated in conjunction with one another. For example, does an individual who suffers from depression turn to alcohol as a coping mechanism? Does an individual who uses alcohol as a coping mechanism become more depressed?
The primary way to enable increased coordination is through electronic record sharing via a standardized, person-centric electronic health record (EHR).
Today, the healthcare community has begun to realize the benefits of a harmonized and interoperable EHR. An interoperable EHR can make treatments more cost-effective, promote evidence-based treatments, support treatment program evaluations that lead to improved quality of decision making and care and lead to improve healthcare outcomes. EHRs also aid in billing, reimbursement and other administrative processes, making the systems beneficial to consumers, payers and providers alike.
Value-based payment (VBP) models are emerging in all areas of healthcare, including human services. Understanding the evolution of payment models is essential to evaluating the impact VBP will have on states and the providers of care.
Transformation of Care: Value-based Payment Models and Certified Community Behavioral Health Clinics is the first in a series of whitepapers aimed at clarifying what lies ahead for states and providers. This paper takes a deeper look at Certified Community Behavioral Health Clinics (CCBHCs), one of the new care models emerging as a pilot program. It focuses on four decision points that represent key moments in determining how to integrate CCBHCs into VBP planning.
This whitepaper outlines the progression from data to wisdom that must take place for behavioral health organizations to make the transition to pay-for-value models.
It covers methods to stratify risk by:
Providers across the care continuum are tasked with being able to produce improved clinical outcomes while reducing cost and increasing patient satisfaction. We explore how value-based care tackles healthcare ’sTriple Aim’ through care coordination and collaboration, bundled payments and connectivity.
The first wave of value-based payment models focused on acute care. Now payers and healthcare systems are looking to extend the models across care settings to take advantage of the benefits offered by whole-person care. The reason is clear: Treatment costs for those diagnosed with chronic disease and mental illness are substantially higher – up to four times higher – than treating people with chronic physical ailments only.
To survive and thrive, post-acute care providers (home health, hospice and senior living facilities) and behavioral health providers (community mental health centers, substance use treatment centers, child and family service agencies) must start planning now to work as equal partners with healthcare systems.
Read this perspective to learn why care coordination may be the ultimate key to improving outcomes and where to start developing the strategies to enable it.
The healthcare landscape is continually changing. That means how home health and hospice agencies deliver services, get paid and measure quality of care are also changing.
This handy guide details the key issues you’ll be facing and how to address these challenges:
The healthcare ecosystem is rapidly evolving and so is the role of post-acute providers. As efforts to lower healthcare costs and manage the continuum of care gain momentum, PAC organizations are playing an increasingly strategic role.
To take full advantage of this opportunity requires a smart technology strategy that spans four key areas: interoperability, care coordination, analytics and the ability to adapt to ongoing changes.
Complete the form to read The Strategic Role of Post-acute Care: Four Technology Strategies to Ensure Success.
HHGM is the most significant change to the home health prospective payment reimbursement model since its inception. Released in July 2017 by Centers for Medicare and Medicaid Services (CMS), HHGM isn’t scheduled for implementation until CY2019. But it has the potential to fundamentally change how home health services are provided and paid for.
Read this perspective from Dawn Iddings, Netsmart senior vice president and general manager, to gain a sense of how these proposed changes could affect your agency.