Better Behavioral Healthcare (Sterner)

Managing Your Online Presence See page 27

Stressed?

Learn how to avoid burnout See page 5

Robots Set To Enter The Healthcare Field See page 19

Industry Updates

Technology Updates Mergers & Acquisitions Policy & Regulation Updates Services & Treatment Updates

Included Publications

Executive Briefing Management Newsletter Market Intel Report

Award Winning Publications

The behavioral healthcare market intelligence & management best practices needed to tackle business challenges, improve decision- making, and maximize organizational profitability.

Letter From the Editor In the past months we have witnessed significant changes and updates impacting the behavioral health field. At Better Behavioral Healthcare magazine we understand the stresses executives and leaders are under to keep up with the latest information and regulations relevant to the field. That is why we believe that a wellinformed leader is the best leader. But being a successful leader in the behavioral health field is more than just knowing the latest news and developments; it is about understanding the information, how it impacts your organization, and the industry best practices to take your organization to the next level. In addition, we feel that becoming a better leader involves personal growth and assessment. We ensure to provide helpful information for executives to become better leaders, whether that is understanding how to manage stress, useful tips on managing staff, or inviting executives to leadership retreats to help get them back to the basics and return them to their team rejuvenated and ready to make a difference.

Leading in the behavioral health field is truly multifaceted Executives have to keep up with the latest news and policies, knowing the best business and industry strategies, and really understanding the best ways to be a leader. It is a tall order to fill, but my team and I hope that with this publication crucial behavioral health jobs can become a little less stressful with the aid of our content. At the end of the day, the goal is to make sure that individuals with complex needs are being provided the best care possible, and that means starting at the top with organizational leaders.

In efforts to better serve you we encourage that our readers write in and answer surveys to ensure that we are covering the topics that matter. Feel free to let us know if there is a new topic or regulation that is impacting your organization and we will cover the content report to our audience.

Ashly Sterner Editor, Better Behavioral Healthcare magazine Page | 1

Our Team Chief Editor Ashly Sterner Chief Designer Ashly Sterner Special Contributor Kimberly Rindt Assisting Editor Elizabeth Kemmery Assisting Editor Emily Sterner Get Involved. Visit our website to learn more about becoming a freelance writer for Better Behavioral Healthcare magazine. www.betterbehavioralhealthcare.wordpress.com

Connect With Us! Better Behavioral Healthcare magazine Facebook Page @BBHm Twitter Page Better Behavioral Healthcare magazine LinkedIn Page

Table of Contents Departments

Page 5 | Avoiding Burnout

It is nothing new that executives and professionals experience high levels of stress, but there are ways to stay ahead of the game and avoid burnout.

Page 19 | We Are Way Past The Jetsons

Back in the day the cartoon show The Jetsons was ahead of its time. Now, robots are becoming a reality as the medical field adopts them for various uses.

Technology Updates Mergers & Acquisitions Policy & Regulation Updates Services & Treatment Updates

Publications Executive Briefing Management Newsletter Market Intel Report

Page 27 | Guide To Managing In the health and human Your Online Presence services field putting patients, the consumes, first is a must.

But, many leaders forget that the experience user have online can be very influential in the provider choices they make.

Powerful Data.

Powerful Outcomes. Web-based Portal Patient and Provider Drill Down Risk Analysis Population and Subpopulation Views Clinical Guidance Intervention Tools Evidence-based Practice Gaps in Care for Co-morbid Conditions Pharmacy Analytics

www.cmthealthcare.com

For more information, contact: David Fotheringham dfotheringham@cmthealthcare.com 919-674-2555

MENTAL HEALTH AMERICA’S 2013 ANNUAL CONFERENCE

JUNE 5-8, 2013 THE GAYLORD NATIONAL RESORT & CONVENTION CENTER National Harbor, Maryland www.mentalhealthamerica.net/go/annualconference

KEYNOTE PRESENTERS Geoffrey Canada, President & CEO of the Harlem Children’s Zone

Dr. James O. Prochaska, Director of the Cancer Prevention Research Center & Professor of Clinical and Health Psychology at the University of Rhode Island

David Granirer, counselor, comic, and founder of Stand Up for Mental Health To learn more about conference speakers, visit www.mentalhealthamerica.net/go/annualconference/speakers.

TAKE ADVANTAGE OF THE EARLY BIRD RATE UNTIL APRIL 15: $75 off full Conference Rate of $375.

Use discount code Council2013 to receive $75 off registration for the full conference rate.

JOIN US FOR OUR CAPITOL HILL DAY ON JUNE 6TH! Join our affiliates and fellow advocates on Capitol Hill and make your voice heard!

NIGHT IN THE LIMELIGHT BENEFIT Join us for Mental Health America’s inaugural “Night in the Limelight” benefit featuring acclaimed actor Jeffrey Tambor from 7:00-9:00 p.m. on Saturday, June 8, 2013, at the Gaylord National Resort.

For more information, visit www.mentalhealthamerica.net/go/nightinthelimelight.

To register and obtain more information about the conference, go to: www.mentalhealthamerica.net/go/annualconference.

Additional questions can be directed to info@mentalhealthamerica.net or 703-684-7722

Avoiding

Burnout

Over the years, executives have become more stressed making stress a very well-known and acknowledged issue in society. Stress has become a daily term in today’s society. To take that a step further, burnout is the epidemic increases stress impacting an executive’s effectiveness and physical health. This exhaustion, or burnout, from stress is being brought up more and more and experts have been implementing new ideas and ways to prevent and manage burnout.

According to experts, burnout is the mental and physical exhaustion you experience when the demands of your work consistently exceed the amount of energy you have available. Some defining characteristics of burnout are that people can’t or won’t do what they have been doing previously. Many people in this situation feel stressed, tired, angry, and trapped. Executive burnout is associated with frequent headaches, inability to shake colds, and quick anger. Experts refer to burnout as the epidemic of the modern workplace.

Executive’s Guide To Preventing Burnout Since the side effects of burnout can hinder effectiveness and productivity it is important to look at ways to prevent burnout.

Meditation

Tomoko Grabosky, a meditation and relaxation instructor at Shippensburg University, believes that meditation helps your body focus on the inside of the brain, not the outside stress providing calmness and clarity, and a much needed break.

Time Management Practices

Dr. Tomoko Grabosky suggests using time management practices such as compiling a calendar that features all the events and meeting while also making sure to allotting necessary breaks. The key is to not overwork yourself and to designate time for relaxation.

Know Your Stress Signs

When stressed, your body has signs to show that you are stressed. These signs maybe different for every person. For example, one stress sign can be that the back of your neck becomes tense. During times of high stress these muscles tense up dramatically and can cause pain. Knowing the warning signs of when your body is under high stress can help make you aware that it is time to take a break.

Unplug

Another suggestion is to “unplug” when you leave the office. This means not being connected to your cell phone of email outside of work. Today, many workers check their email during off work hours in case a problem arises. Checking your emails and handling problems may sound harmless, but overtime it will become a habit and doesn’t off you time to re-energize and recover.

Treat Yourself

Take time to reward yourself. Some executives treat themselves by taking a long weekend every now and then. Taking a long weekend can refresh motivation and get you back on track. You can also try something interesting or new such as a hobby to take your mind off your current work and will help to restore energy.

Page | 6

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Technology Updates New Qualifacts Carelogic Integration Hub Improves Interoperability Of Behavioral Healthcare Data For Better Outcomes NASHVILLE, Tenn., October 27, 2015 – Qualifacts Systems, Inc., the largest web-­based platform for integrated clinical, financial, reporting and administrative solutions for the behavioral health and human services industries, today unveiled CareLogic Integration Hub™ to facilitate efficient data exchange and interoperability between behavioral healthcare providers and their healthcare counterparts.

The new CareLogic Integration Hub™ helps improve the quality of care Qualifacts behavioral health customers deliver to their clients by connecting CareLogic Enterprise, the company’s comprehensive electronic health record (EHR) platform, with other healthcare technology.

CareLogic Integration Hub enables CareLogic healthcare data to be exchanged throughout the entire ecosystem of healthcare providers, without the costly and time-­intensive administrative burden, which is currently a barrier to coordinated care.

“The behavioral health industry is evolving towards integrated care models that require inter-operable systems.

We believe care coordination technology integrated with an electronic health record is essential for behavioral health organizations looking to participate in value-based payment models,” said David Klements, President and CEO of Qualifacts.

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“The CareLogic Integration Hub™ will ensure our customers can efficiently and cost effectively exchange data with their healthcare counterparts and ultimately this means our customers will continue to grow and serve more clients.”

The CareLogic Integration Hub™ accomplishes the following for Qualifacts behavioral health customers: •

• • •

Improves care coordination with instant access to previously siloed data from other Electronic Health Records (EHR), Health Information Exchanges (HIEs) and laboratory systems Increases visibility into client health with the most accurate, up­-to-­date information Meets emerging regulatory requirements such as Health Homes and Community Behavioral Health Centers (CCBHCs) Decreases error­-prone manual data entry for lab results, admissions, discharges, and medications

The CareLogic Integration Hub™ is available to Qualifacts customers, and is fully integrated with the company’s comprehensive electronic health record (EHR) platform, CareLogic Enterprise.

Better Behavioral Healthcare | www.betterbehavioralhealthcare.wordpress.com | December 2015

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Technology Updates Nation’s Largest County Mental Health System Launches Tech-Enabled Holistic Care Initiative The Los Angeles County Department of Mental Health (LACDMH) and Tarzana Treatment Centers, Inc. (TTC) have launched a groundbreaking initiative that allows behavioral health clinicians and primary care physicians to safely and securely share vital, authorized client and patient data in real time – often at co-located facilities – to treat the mind and body. The program is a component of the county’s Health Neighborhoods project, which recognizes that multi-agency change models are most effective at improving population-level health and wellness outcomes.

In this new integrated care initiative, behavioral health clinicians at LACDMH’s San Fernando Mental Health Center (SFMHC) will have access to electronic health record (EHR) data about TTC’s clients’ co-occurring physical health conditions and medications. Likewise, TTC will receive EHR data from SFMHC. According to data from the Substance Abuse and Mental Health Services Administration (SAMHSA), as many as 70% of patients with severe mental illnesses served by the public mental system have co-morbid medical conditions such as heart disease, diabetes, asthma and COPD. Behavioral health clinicians are an integral part of “whole person” care, and need access to complete information to make informed treatment decisions.

In addition, primary care clinicians will have access to authorized EHR-based behavioral health and addiction treatment information, providing a more complete view of the person’s overall health status.

“By breaking down the silos that exist between mental health, physical health and addiction treatment services, we can reach our goal of improving the full health and well-being of our residents,” said Robin C. Kay, Ph.D., chief deputy director for the Los Angeles County Department of Mental Health.

All data is exchanged electronically between TTC and LACDMH in a protected manner in a standard CCD (Continuity of Care Document). However, the system also allows for inclusion of a patient narrative, giving clinicians the ability to communicate even more context than the structured data communicated in the CCD.

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The data exchange and integration is facilitated by the Netsmart CareConnect care coordination solution, and includes the ability for the providers to do in-depth referrals for improved continuity of care, conduct ongoing treatment monitoring, and receive emergency alerts for situations such as a failure to take prescribed medications.

“Netsmart is excited to partner with the Los Angeles County Department of Mental Health and Tarzana to enable holistic health and wellness by effective data sharing and transition of care among all providers,” said Netsmart CEO Mike Valentine. “This care coordination initiative is designed to improve outcomes, reduce health-related costs and more deeply engage consumers.”

Both LACDMH and TTC have long-utilized Netsmart’s myAvatar CareRecord (electronic health record). Netsmart is also LACDHMH’s technology partner for IBHIS, the county’s comprehensive behavioral health clinical, administrative and financial information system.

TTC is offering primary care services at the SFMHC twice weekly to enable real-time treatment of mind and body. In addition, 24/7 referrals have been enabled from SFMHC to other services, including TTC’s substance use disorder treatment services. TTC operates seven primary care clinics which are also linked to SFMHC via CareConnect.

“You can’t properly address someone’s mental health if they’re not physically well,” explained Albert Senella, CEO and President of Tarzana Treatment Centers. “Likewise, mental health is directly linked to effectively managing physical wellness.”

The integrated care program is made possible by a Primary and Behavioral Health Care Integration (PBHCI) grant from SAMHSA. The objective of the PBHCI grant is to enhance the consumer experience of care (including quality, access, and reliability) while reducing/controlling the per capital cost of care. Results – including symptoms reduction, patient engagement rates, and costs of care – are being tracked in the Netsmart CareRecord and will be reported to SAMHSA twice a year.

Technology Updates Mental Health Apps Becoming More Relevant With Therapists & Consumers There are currently 3,000 mental health apps available across the Apple App Store and Google Play. Of the 3,000 apps, less than 1% of have been studied for their efficacy.

However, there are currently 114 studies of mental health apps registered in ClinicalTrials.gov’s database of behavior and mental disorder clinical research studies. Mental health apps can be beneficial for consumers and therapists.

The app has more than three million users since it was introduced in 2012. Another available is called Joyable, which promises to help reduce social anxiety. Mood 24/7 is a mood-tracking app based on research from Johns Hopkins that found asking patients to take daily stock of their mood helped make them more aware of patterns and empowered them to reach out for help when depressed.

Some mental health apps include Headspace, which offers several hundred hours of guided meditation aimed at reducing stress or anxiety, increasing focus and creativity, or strengthening relationships.

This was reported by The Wall Street Journal at MentalHealth Apps Make Inroads With Consumers and Therapists on September 27, 2015.

Janssen Addresses Challenges Of Caregiving In Alzheimer’s Disease With New Healthy Minds Videos A new series of videos about caregiving in Alzheimer’s disease is being released by Janssen Research & Development, LLC (Janssen) as part of its Healthy Minds video library, which offers discussions about progress in brain research, treatment options, and resources for people with brain diseases, their families, and communities. The new videos can be viewed on the Janssen Global YouTube channel.

The videos capture discussions about the challenges faced by Alzheimer’s caregivers and offer strategies and resources to help them.

Featured in the videos are: Meryl Comer, a leading Alzheimer’s disease advocate and CEO of the Geoffrey Beene Foundation Alzheimer’s Initiative; Jed Levine, Executive Vice President, Alzheimer’s Association, New York Chapter; and Husseini K. Manji, M.D., a psychiatrist and Global Head of Neuroscience at Janssen. The series is hosted by Emmy Award-winning journalist Vicki Mabrey.

The new videos address the following topics with Dr. Manji and guests: the challenges of caregiving; understanding Alzheimer’s and the caregiver role; caregiver planning and resources; and caregiving with dignity and hope for the future. The video series is part of Janssen’s Healthy Minds initiative, dedicated to advancing Neuroscience research, news and information regarding mental health.

The video project serves as a platform to continue Janssen’s leadership and innovation in Neuroscience, mental health education, public health and advocacy.

This was reported by PRNewswire on November 10, 2015.

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Mergers & Acquisitions St. Joseph Health, Providence Health Molina Healthcare To Acquire And Services, To Form New Company Loyola Physician Partners’ Medicaid In Merger Program Joseph Health, which operates two hospitals and employs some 4,000 people in Sonoma County, announced the creation of a new health care organization through a partnership with Providence Health & Services, a large Catholic health care provider that serves the Pacific Northwest. With the launch of the new parent organization, Providence St. Joseph Health, the two partners expand their presence in the western United States, with 50 hospitals in Texas, New Mexico, California, Oregon, Washington, Montana and Alaska. The merger could potentially have a significant impact on the local economy as St. Joseph Health is one of the largest private employers in Sonoma County. It has an additional 1,300 employees in Napa County. St. Joseph Health operates Santa Rosa Memorial Hospital, Petaluma Valley Hospital and Queen of the Valley Medical Center in Napa. The local health care provider, which is affiliated with Annadel Medical Group and Queen of the Valley Medical Associates, operates three urgent care centers in Rohnert Park, Windsor and Santa Rosa, as well as two hospices in Santa Rosa and Petaluma.

This was reported by New Directions Behavioral Health on November 25, 2015.

Molina Healthcare, Inc. and Loyola Physician Partners, LLC, jointly announced that Molina Healthcare of Illinois, Inc., a wholly owned subsidiary of Molina Healthcare, Inc., has entered into a definitive agreement to acquire certain assets relating to Loyola Physician Partners’ Medicaid business in Illinois. As part of the transaction, Molina Healthcare of Illinois will receive the right to transition Loyola’s Medicaid members in Cook County and assume certain assets related to the operation of the Medicaid business. The closing of the transaction is expected to occur in the first quarter of 2016. Financial details of the transaction were not disclosed.

Loyola, through the Accountable Care Entity Loyola Family Care, provides a medical home for approximately 20,000 members in the Medicaid Family Health program in Cook County. Solely owned by the Loyola University Health System (LUHS), Loyola’s provider network includes Loyola University Medical Center, Gottlieb Memorial Hospital, LUHS employed physicians, affiliated physicians, Pillars, Proviso Township Mental Health Commission, and Catholic Charities of the Archdiocese of Chicago.

This was reported by Business Wire on October 9, 2015.

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Better Behavioral Healthcare | www.betterbehavioralhealthcare.wordpress.com | December 2015

NATIONAL COUNCIL MAGAZINE • 2013, ISSUE 1 / 25

Policy & Regulatory Updates HHS Issues Rules To Improve EHRs With Added Simplicity The Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) released final rules that simplify requirements and add new flexibilities for providers to make electronic health information available when and where it matters most and for health care providers and consumers to be able to safely exchange that information.

The final rule for 2015 Edition Health IT Certification Criteria and final rule with comment period for the Medicare and Medicaid Electronic Health Records (EHRs) Incentive Programs will help continue to move the health care industry away from a paper-based system. As part of the regulations, CMS announced a 60-day public comment period to gather additional feedback about the EHR Incentive Programs going forward, in particular with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which established the Merit-based Incentive Payment System and consolidates certain aspects of a number of quality measurement and federal incentive programs into one more efficient framework.

This was reported by U.S. Department of Health & Human Services on October 13, 2015.

FDA Accepts First Digital Medicine New Drug Application For Otsuka & Proteus Digital Health Otsuka Pharmaceutical Co., Ltd. and Proteus Digital Health announced that the U.S. Food and Drug Administration (FDA) has determined that the New Drug Application (NDA) for the combination product of ABILIFY (aripiprazole) embedded with a Proteus ingestible sensor in a single tablet is sufficiently complete to allow for a substantive review and is considered filed as of September 8, 2015. The ABILIFY tablet contains an ingestible sensor that communicates with a wearable sensor patch and a medical software application for measuring adherence in the treatment of adults with schizophrenia, acute treatment of manic and mixed episodes associated with bipolar I disorder, and as adjunctive therapy for the treatment of major depressive disorder in adults.

If approved by the FDA, health care professionals will have the ability to prescribe ABILIFY tablets with the Proteus ingestible sensor embedded in the tablet. This drug-device product can provide the patient with a treatment option to help manage symptoms while allowing the caregiver and health care professional to measure medication adherence and other patient metrics.

This was reported by Business Wire on September 10, 2015.

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Better Behavioral Healthcare | www.betterbehavioralhealthcare.wordpress.com | December 2015

Booth #200 A BREAKTHROUGH IN NEUROMODULATION for Depression

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In an NIMH-funded, independent, randomized controlled trial, patients treated with TMS using a clinical-trial version of the NeuroStar TMS System were four times more likely to achieve remission compared to patients receiving sham treatment (P = 0.0173; odds ratio = 4.05).1 NeuroStar TMS Therapy is only available by prescription. Š2015 Neuronetics, Inc., Malvern, PA 53-51142-000 Rev A 10/15

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1. George MS, et al. (2010). Arch Gen Psychiat 67(5):507-516.

Services & Treatment Updates CMS Awards $67 million In Affordable Care Act Funding To Help Consumers With 2016 Health Insurance Marketplace Coverage With Marketplace Open Enrollment set to begin on November 1, 2015, the Centers for Medicare & Medicaid Services (CMS) announced grant awards totaling $67 million to support outreach efforts designed to connect people with local help as they seek to understand the coverage options and financial assistance available at HealthCare.gov. Awarded to 100 organizations located in 34 states that operate Federally Facilitated Marketplaces and State Partnership Marketplaces, the three year-long Marketplace Navigator grants will fuel efforts to help consumers enroll in a health plan that fits their budget and best meets their family’s needs.

Navigators and assisters are trained specialists who provide consumers in their communities with in-person help, answering their questions about their health insurance and financial assistance options and assisting them as they complete their application. Of the Navigator grantees awarded for this three-year cycle, 67 are returning grantees.

This was reported by the Centers for Medicare & Medicaid Services on September 2, 2015.

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Maryland Receives $1.5 Million In Federal Grants To Prevent Youth Violence The Departments of Justice (DOJ) and Health and Human Services (HHS) announced $1.5 million in new federal grants to support violence prevention efforts in Baltimore, MD. These grants — to be administered by the Office of Juvenile Justice and Delinquency Prevention (OJJDP) and the Office for Victims of Crime (OVC) — were awarded as part of the Department’s public health approach to prevent and reduce crime in communities. The three grants from the U.S. Department of Justice include: •

National Forum on Youth Violence Prevention funding to implement strategies and evidence-based programs to reduce youth violence. The Baltimore City Health Department and the Baltimore Public School System will implement a school-wide positive behavioral interventions and support model.

•

OJJDP funding to integrate the faith community into activities to prevent and reduce youth violence and victimization within and around the Safe Streets Baltimore areas.

This was reported by the Office of Juvenile Justice and Delinquency Prevention on October 28, 2015.

Better Behavioral Healthcare | www.betterbehavioralhealthcare.wordpress.com | December 2015

We ‘re Way...

Past The Jetsons

What did I think of the three robots at the 2015 OPEN MINDS Technology & Informatics Institute? Raymond T. Heipp, Ph.D., the Director of Assistive and Educational Technologies of Westminster Technologies, Inc., summed it up best in his presentation when he said, “Many people take a look at our NAO robot and say that it’s just like the robot on the Jetsons.

Page | 19

My response to them is that we’re far past the Jetsons right now.” I couldn’t agree more. I was surprised at exactly how far robotic technology has come and the many potential uses in systems serving consumers with a wide range of needs. The three robots we saw this week are each quite distinct in terms of their capabilities.

During the presentation by Dr. Heipp and Cory Kidd, Ph.D., Chief Executive Officer, Catalia Health, Are Robots The Future Of Health Care? A Discussion With Robotics Innovators, I was surprised to learn that robots are so advanced at gathering consumer data, facilitating consumer education and engagement, leading therapeutic activities, teaching social skills, monitoring medication, and assessing the need for in-person case management intervention. Robots are being used to serve kids with autism, consumers in nursing homes, and cancer survivors. And that wasn’t all that surprised me. There were a few other items:

NAO

Surprise #1

The most surprising information in the presentation was that people are more responsive to robots than to Internet-based avatars or smart-phone apps. Consumers are “engaged” with robot-delivered care management longer, and often voluntarily wish to continue robotic interventions. The theory (which I am still trying to wrap my head around) is that people consider advice from something with a physical presences as more credible. In fact, people seem to “bond” with their robots – giving the robots names and clothing.

Surprise #2

NAO is a 24-inch-tall humanoid companion service robot that can be programmed to provide social interaction skills training. It was developed by Aldebaran Robotics and can move independently; process two video streams; and comes with Nuance, a vocal recognition program with a “word spotting” function that enables the program to isolate and recognize specific words within sentences or conversation.

Mabu

Artificial intelligence (need I say more?).

Surprise #3

Maintenance of robot functionality can be done by remote staff using Internet linkage.

Surprise #4

Robots can be “loaded” with custom functionality. They can have facial recognition software and can recognize who they are talking to, whether that be the consumer, caregiver, or someone else.

They can produce and record visual images or audio tracks. They can be embedded with logic for care management or consumer assessments or therapy programs.

Surprise #5

Robots are Health Insurance Portability and Accountability Act (HIPAA) compliant and can be set up to generate data that is electronic health record (EHR) inter-operable.

Surprise #6

Mabu is a personal health care companion, socially interactive robot whose conversations are tailored to each consumer. The robot provides information and support for sufferers of chronic diseases like diabetes, arthritis, cancer, and heart disease, and will be rolled out this year to help a particular group of patients manage the medication portion of their treatment. Mabu isn’t mobile, but can make eye contact while carrying on a conversation with someone and is capable of simple gestures with its head.

ROBORITA

The price of robots is declining with volume (like most tech products). The NAO is now only $9,000 and the Mabu leases for $150 – $200 per month.

Like all technologies, I think it will take a while for robots to move from pilots to scalable. But as the functionality increases and the price continues to decline, the return-on-investment (ROI) opportunities are endless. Care manager for the super-utilizer population; monitoring children in foster families, companions for individuals in solitary confinement in the corrections system; supplied to consumers upon discharge from the hospital; monitoring the status of medically or emotionally fragile individuals who are living at home…the list could go on. The possibilities are probably limited by our imagination in service line development – and our willingness to re-imagine the fundamentals of consumer engagement.

roborita[1]RITA – RITA provides a platform to improve and increase patient engagement. It can be used anywhere there’s a need to reach out to a physician, especially in remote areas, or to augment existing services in clinics, hospitals, and other community care settings.

Executive Briefing Greetings from D.C. and the opening day of the 2015 OPEN MINDS Technology & Informatics Institute. Paul Grundy, M.D., founding President of the Patient-Centered Primary Care Collaborative and IBM’s Director of Global Healthcare Transformation, opened the day with his keynote presentation, Making The Transition To ValueBased Payment: Transforming Your Organization For The New Normal. Often referred to as the “godfather” of the medical home, Dr. Grundy took us through the history of the evolution of medical homes and the early data on their impact.

In this presentation, he discussed the confluence of the need for better population health management and individual care coordination – along with the shift to valuebased payment. On the payment front, he reviewed the move to pay-for-value – even in Medicare reimbursement.

And he emphasized that by 2018 almost 90% of Medicare payments would be moved away from traditional fee-forservice.

At the same time, the consumer delivery system model is shifting to medical homes as the preferred vehicle for coordinated consumer care management. What does this evolution look like? Care is proactive, standardized, and coordinated; And providers track and measure all care, and follow-up and improve care based on the metrics.

His discussion of the emerging dominance of the medical home model – and its effectiveness in reducing the use of specialty care – brought me to my question at the end of the session: What is the role of a specialist organization in a health care market dominated by medical homes? His answer was straightforward. “Specialists need to choose – are they a comprehensivist or a partialist?

Page | 21

In other words, do they want to role of managing all of an individual’s health and well-being? Or do they want to specialize in the conditions that effect a specific part of the body? The medical home model decreases the utilization of specialists – but we need great specialists. And, the specialist organizations need to choose.”

To me, this is the crux of the strategic crossroad for most specialist organizations that have revenue from the health care system. The boards and executive teams of these organizations are at a crossroads – and need to choose.

And, they need to realize that not choosing is a choice – and one with consequences. Later in his presentation, Dr. Grundy described the fate of the “non-choosing” and “nonchanging” health care organizations in a market where the medical home model became the dominant consumer care management model. After a few years, those organizations ceased to exist.

So the strategy question for specialist organizations – market positioning as comprehensivist or as a partialist?

If your organization is facing this decision point in your market, perhaps you can take comfort in the words of Peter Drucker: “Whenever you see a successful business, someone once made a courageous decision.” But making this fundamental decision in a timely manner is critical.

And to quote the less cerebral but always interesting Yogi Berra: “When you come to the fork in the road, take it.”

Better Behavioral Healthcare | www.betterbehavioralhealthcare.wordpress.com | December 2015

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Management Newsletter What Are The Opportunities In Responding To Government RFPs?

How To Track & Vet RFPs: Find The Right Opportunities For Your Organization

One fundamental business development question for health and human service organizations is whether to respond to government RFPs. For many types of health and human services, the only avenue for access to funding is to respond to these competitive RFPs. But before investing in the process and the people, the question is what are the opportunities? So far in 2015, the OPEN MINDS Government RFP & Contract Database has identified a total of 10,191 ...

For most organizations in the health and human service space, it is absolutely necessary to search for new complementary business development and revenue opportunities. For many, this means responding to requests for proposals (RFPs). But, with so many so many opportunities out there, it can be hard to track and identify which ones are the best fit for your organization. This process requires a two-step process – one for tracking RFPs and one for vetting ...

Is SAMHSA To Blame For A Broken Mental Health System?

Responding To RFPs – It’s An Art & A Science

Two members of Congress presented markedly different views on how to reform the nation’s mental health system at a briefing here. Rep. Tim Murphy (R-Pa.), speaking at a forum hosted by the National Journal and Janssen Pharmaceuticals on Wednesday, laid part of the blame for access issues in mental health on the Substance Abuse and Mental Health Services Administration (SAMHSA), an agency he has long derided. The congressman has introduced legislation known as the “Helping Families in ...

Responding to competitive proposals is a whole different ballgame than creating unsolicited proposals for payers, health plans, and government agencies.

But, sometimes it is the only path to getting the business. The proposal planning production process can be extremely challenging, especially for smaller organizations that don’t have a deep bench of staff from which to draw both experience and the staffhours to devote to the process. But once you’ve made the decision to compete for something and ...

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Better Behavioral Healthcare | www.betterbehavioralhealthcare.wordpress.com | December 2015

Market Intel Report:

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How Do States Monitor Atypical Antipsychotics Prescribed To Children?

Market Intelligence Report | by Market Intelligence Team | September 4, 2015

Anti-psychotic drugs were developed to specifically treat psychiatric disorders in the adult population.

Over time the drugs have been increasingly prescribed to children as young as age three. Although some anti-psychotics have been approved by the Federal Drug Administration (FDA) for use in children, there are very few long-term studies that show the efficacy and safety of these drugs for this age group.

This has caused many concerns about prescribing anti-psychotics to children, including the side effects, utilization patterns, and off-label prescribing.

Anti-psychotic medications are part of the psychotropic drug class which also includes: stimulants (most commonly used for the treatment of ADHD), antidepressants, anti-anxiety medications, mood stabilizers, and anticonvulsant medications.

Within anti-psychotics there are two main classes: first generation anti-psychotics (FGA) developed in the 1950s and second generation anti-psychotics (SGA), also known as atypical anti-psychotics, which were developed in the 1980s. Although both classes have serious adverse side effects, the type of side effects vary between the drug classifications.

FGAs are associated with neuromotor side effects, such as sedation, tardive dyskinesia (involuntary movements of the face and jaw), and dry mouth. SGAs are associated with weight gain, increased lipid and prolactin levels, development of type 2 diabetes, and cardiovascular issues.

Atypical anti-psychotics also have a black box warning, the highest level that the FDA issues, warning about the risk of hypoglycemia and diabetes mellitus.

Questions Addressed • Why Are There Concerns About Prescribing Anti-psychotics To Children?

• How Many Children Are Prescribed Antipsychotics?

• What Are The FDA-Approved Ages For Atypical Anti-psychotics?

• What States Have Guidelines On Prescribing Anti-psychotics To Children?

• What States Have Initiatives To Monitor Antipsychotics Prescribed To Children In Foster Care?

• OPEN MINDS Resources On Use of Antipsychotic Drugs For Children

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Guide To Managing Your Online Presence

When working in the behavioral healthcare field it may seem like there are a million other areas to focus on other than your organization’s online presence. But the truth is, if you aren’t viewing your organization online you may not be aware of the possible relationship your audience is having with your brand and organization. Don’t fall behind, get your brand and organization on track and excelling in online consumer relationships.

Tim Snyder, Executive Vice President of Marketing at OPEN MINDS has a detailed guide of best practices for managing organization’s online presence and band and why it is important for today’s organizations.

Mr. Snyder has been leading marketing initiatives for behavioral healthcare organization for over nine years. He is also author of a number of articles including Best Practice Leadership Is Leadership With Analytics, Yelp Comes To Health Care – One More Reason For Online Reputation Management, Want More Referrals? Step Up Your Web Marketing Game, The Goal: Be A Golden Brand, and more. Mr. Snyder has a number of suggestions so organizations can succeed in the game of reputation management.

So Why Does This Matter?

It may come as surprise, but more and more individuals are looking to online review and ratings sites to decide which healthcare provider to choose. Mr. Snyder refers to this change as the “Empowered Consumer Revolution,” where purchasing decisions are made by informed consumers who take the time to shop around before deciding where to receive services. “It is estimated that 77 percent of individuals now research treatment options and provider organizations online every year, “explains Mr. Snyder.

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It All Starts With Your Website & Its Ranking Ask yourself, how do individuals find your organization online? If they are like the majority of us, they go to Google and search for relevant results. By understanding this process organizations can increase its success by making it easier for consumers to find their organization and services online.

The “Need-To-Know” About SEO There are a few things Mr. Snyder recommends. The first being to make sure your organization is doing everything possible to implement search engine optimization (SEO).

This can be accomplished by ensuring that within the website all articles and content includes the proper titles and tags, there is an about us page, an accurate address and phone number are available, in addition to many other suggestions.

What you get out of researching SEO and making it part of your website is that Google and other similar search engines will rank your organization higher. And if you don’t already know, this ranking can make a huge difference in whether your audience even makes it to your website. It has been found that individuals focus on the top left-hand results in search engines (visible in the user heat map).

Additionally, if you aren’t making the first page of results you may have an issue, because an estimated 68 percent of searchers don’t go past the first page of search results, says Mr. Snyder.

Responsive Web Design Is A Must Another way to improve your websites visibility is by making sure it has a responsive web design (RWD). This means that the website is built and coded to provide optimal viewing to users across all platforms from desktop to mobile. This is a vital layout because searchers rely on their smart-phone to look up healthcare services, in addition to downloading health apps.

In a report released by Accenture discussing eHealth trends we see a dramatic shift in the way healthcare is administered and ultimately changing the way healthcare professionals interact with their consumers.

In terms of accessing organizations and their services online, patients report that the number one reason for using mobile phone apps is for health monitoring.

Additionally, Accenture revealed that 41 percent of health executives strongly agree that the next generation of platforms will be led by industry players and leaders working within the field, not tech leaders. Plus, 76 percent of patients say the use of technology to manage their health has the potential to improve their health.

With the direction technology is taking and enhancing healthcare it is important for organizations to ensure that their consumers are having the best online experience.

For this to happen organizations need to stay on top of the technology trends and developments. Online presence provides consumers with the next level of connectivity and ultimately leads to better overall patient care.

Living In A World Where Ratings Rule Today there are new game changers influencing consumers’ decisions when choosing a provider for services, and that game changer is the online review.

Consumers are now flocking to comparison websites like Healthgrades and Vitals to find out as much as they can before making a decision. Let’s face it, people trust online reviews. Andy Ibbotson, vice president of National Research Corporation, told CNBC that online reviews are important, because 77 percent of consumers begin their search for a healthcare provider online, he says, with 1 in 3 patients choosing another physician after reading negative reviews on the web. As you can see, there is a huge weight placed on the initial impression a consumer experiences with an organization’s brand.

Another important aspect to consider, which Dr. Anthony Oliva discusses in her article on Nuance, is the rise of the millennial population. Dr. Anthony Oliva reports that millennials are estimated to spend $200 billion by 2017 and nearly $10 trillion over their lifetime. So why is this so important? It goes back to the concept that this particular population is more likely to turn to online and technology resources to assist in making their purchasing decisions when it comes to healthcare. The more organization can tailor to this population and improve their experience the better the organizational results. Basically, happy patient equals a happy organization.

Social Media Matters Just like with online review sites, don’t forget that social media sites can be a great way to educate your target consumers about your organization and what they do.

Social media also lends itself to speaking about topics and issues impacting your practice and overall patient care.

Nicole Garris, the Marketing Manager for PsychU, provides some insight for social media channels. “These channels can be a great way to leverage avenues for fundraising and referral generation,” she said. Social media is another opportunity to accumulate positive online reviews. “If consumers feel like others are engaged and happy with your company’s brand, along with the product or services your company provides, they will be more likely to use those products/services. In turn they will be more likely to make recommendations,” said Garris.

As outlined, an organization’s online presence and reputation isn’t just one thing. The relationship that users have with a brand or organization is a combination of website functionality, search engine optimization, online reviews and social media presence. Today, the organizations that will succeed will be those that understand how users make decisions and choose services.

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HealtH is Mental infographicdata B

A

1 in 5

people suffers from mental illness; approximately 57.7 million Americans every year.

Mental illness affects everyone across age, sex, and race. percent

8 Prevalence of Serious Mental Illness Among U.S. Adults by Sex, Age, and Race in 2008

6 4

OverAll Sex

2

49%

Age rAce

0 2+ races

AI/AN*

Asian

Hispanic

Black

White

50+

26 – 49

18 – 25

Male

Female

Overall

AI/AN = American Indian/ Alaska Native

C

Among Medicaid beneficiaries with disabilities, 49%

have

a mental illness.

D

United States

grade for mental healthcare

e

Mental illness drains our economy of more than $80

billion every

year; 15% of the total economic burden of all disease.

f

$80 billion

A recent study estimates that serious mental illnesses cost society $255.4 billion annually in lost earnings in the U.S.

g

50%

More than half of all prison and jail inmates have a mental health problem.

– $255.4 billion h

Up to

2

3 of homeless adults

suffer from chronic alcoholism,

14 / NATIONAL COUNCIL MAGAZINE • 2013, ISSUE 1

I

1

4 of all Social Security

drug addiction, mental illness, or

disability payments are for

some combination of all three.

individuals with mental illness

J More than

K

36,000

In the public system, those with serious mental illness die

die by suicide every year.

That’s like losing the

25 years sooner

population of Green Bay,

than the general population –

Wisconsin, every three years.

men at about age 53 and women at age 59.

53

age

L

250,000

professionals

M

Globally,

59

age

3 of the 6 leading

disabilities are due to mental illness

Our nation’s community behavioral health

(depression, schizophrenia, and

organizations employ more than 250,000

bipolar disorder).

people who care for 8 million adults and children with mental and addiction disorders.

Success Rates

O

N

Mental health treatments work.

80% bipolar

P

90%

of people

being treated recover.

70%

Major depression, panic disorder, OCD

Up to

60% Schizophrenia

These success rates are comparable to those for physical healthcare.

and 70-80% asthma diabetes

Q YET

2

3

go without

treatment, mostly because of inability to access care and stigma.

60-70% cardiovascular disease 41-52% heart disease

What you can do SOURCES | World Health Organization | SAMHSA | CDC | NAMI | NIMH | Kessler, R.C., Heeringa, S., Lakoma,

Take a Mental Health First Aid course www.mentalhealthfirstaid.org

M.D., Petukhova, M., Rupp, A.E., Schoenbaum, M., Wang, P.S., and Zaslavsky, A.M. Individual and Societal

Advocate for better resources for mental health www.thenationalcouncil.org/cs/advocate_now

Report. Mental Health: New Understanding, New Hope, 2002. | Health care reform for Americans with severe

Talk to your doctor about your mental health

Implications for treatment, insurance and outcomesNATIONAL evaluation.COUNCIL Journal of the American Medical Association.

MAGAZINE • 2013, ISSUE 1 / 15

Effects of Mental Disorders on Earnings in the United States: Results from the National Comorbidity Survey Replication. American Journal of Psychiatry 2008; 165:703-711. | World Health Organization. World Health mental illnesses: Report of the National Advisory Mental Health Council. American Journal of Psychiatry 1993; 150:1447-1465. | McLellan TA, Lewis D, O’Brien C, Kleber H. Drug dependence, a chronic medical illness: 2000; 284: 1689-1695

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