Integrate Physical & Behavioral Health

The Maine State Innovation Model award is funding the following efforts to integrate physical and behavioral health:

Implement MaineCare Behavioral Health Homes Initiative - Through the MaineCare Behavioral Health Homes Initiative, the Department provides monthly reimbursement to community mental health agencies qualified as Behavioral Health Home Organizations (BHHO's) to support MaineCare members with Serious and Persistent Mental Illness and children with Serious Emotional Disturbance. Members enrolled in this service receive integrated, intensive care management of mental and physical health needs; assistance with transitions of care between residential, community-based, and/or hospital settings; peer supports; and other services. Each BHH organization partners with one or more primary care Health Home practices to achieve the relationships and systems necessary for truly integrated care provision.

Behavioral Health Homes are slated for implementation on April 1, 2014. 24 BHHOs with about 80 individual sites will be participating. The Department is targeting 5,000 enrollees for this first year. While a small population, the members represent some of the highest need MaineCare members. Individuals with SPMI die, on average, 25 years earlier than the rest of the population. They often suffer from poor physical health in addition to their mental health and substance abuse issues, and account for a disproportionate share of MaineCare costs.

Behavioral Health Homes will result in such improvements as:

• Vastly improved coordination between mental health and physical health providers, including BHH organization use of Electronic Health Records and the Health Information Exchange;
• Reductions in inpatient readmissions;
• Less non-emergent Emergency Department use;
• Improved self-management of diabetes and other chronic conditions;
• Provision of peer and family supports.

Behavioral Health HIT Reimbursement Grant - HealthInfoNet (HIN) will use SIM funding to support behavioral health organizations with reimbursements towards improving Electronic Health Records technology and participation in health information exchange (HIE). HIN will also support behavioral health organizations in their measurement of quality of care using their interoperable data. The goal is to add up to 20 new behavioral health organizations to HIN's HIE by 2016.

Provide QI Support for Behavioral Health Homes Learning Collaborative - MaineCare Behavioral Health Homes Initiative Behavioral Health Homes Learning Collaborative: Maine Quality Counts will support a Learning Collaborative for 27 Behavioral Health Home organizations. The Learning Collaborative will offer practitioners the opportunity to come together in a structured way to learn from national, state, and local experts and from each other to improve the quality of services they provide. The BHH Learning Collaborative will focus on evidence-based best practices to improve the integration of behavioral and physical health services to improve care for adults with Serious Mental Illness (SMI) and children with Serious Emotional Disturbance (SED). Additionally, the Collaborative will seek to identify best practices that can help BHHOs enhance coordination of care and bring about improvements and efficiencies that will help to decrease costs. The Learning Collaborative will incorporate provider and consumer perspectives and will present evidence-based and emerging best practices to participants for shared learning. Participants will be involved in a series of meetings to learn about best practices in chosen areas, quality improvement methods, and change ideas, and to engage in peer learning where participants share experiences on what has worked in their settings. Quality Counts will offer three day-long Learning Sessions per year as well as conduct site visits to assess baseline; hold webinars to share best practices and innovative approaches; and provide technical assistance as needed.

Provide Learning Collaborative for MaineCare Health Homes - Maine Quality Counts (QC) will be providing quality improvement support to 80 primary care practices participating in the MaineCare Health Homes (HH) initiative by providing direct outreach and support, as well as bringing these HH practices into the PCMH Learning Collaborative. This support includes conducting a baseline onsite assessment of each HH practice to assess the degree to which they have implemented the PCMH Core Expectations, as well as ongoing support provided by a QC Quality Improvement Specialist. The PCMH/HH Learning Collaborative also includes two to three day-long central Learning Sessions, as well as two regional meetings annually that bring practice teams together to learn from national and local experts and to share best practices on implementing the PCMH/HHs model of care.

Connect Behavioral Health organizations to the Health Information Exchange - HealthInfoNet aims to connect up to ten Behavioral Health organization's medical records systems to begin to collect data to incorporate into the current HIE which has been limited to non-behavioral health data.