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Addressing mental health issues improves patients’ physical health
Only five percent of the patient population is complex, yet they account for more than half of healthcare costs, according to Cartesian Solutions, Inc.™. Of that five percent, two-thirds have concurrent mental and physical health issues.
Poor communication between physicians who treat physical issues and providers who treat mental problems can cause complex patients to consume more resources. The lack of communication is due to the reimbursement model; it pays for physical treatments and mental treatments separately
Before the advent of managed care, physicians managed a patient’s physical and mental health problems. Some physicians owned treatment centers for the treatment of alcoholism, eating disorders, and other behavioral health issues, says Rebecca Perez, RN, CCM, CPUM, president and owner of Carative Health Solutions. However, payers realized that those resources were abused and have separated physical and mental health reimbursement, thereby limiting access to mental health treatment.
Limited access has caused a segment of the patient population to remain untreated, potentially causing them to seek more physical health treatment, thereby consuming more resources.
Perez is part of a growing movement addressing that issue by striving for a more integrated care management model that assesses patients’ physical and mental health issues simultaneously.
“The thinking is coming full circle again where we need to treat the patient as a full person and not a disease,” says Perez.
Perez and Roger G. Kathol, MD, CPE, president of Cartesian Solutions, Inc.™, train case managers to assess a patient’s mental health as part of their interaction with that patient. This enables case managers to ensure the patient’s plan of care includes services that address the patient’s behavioral and psychological needs.
Recognizing how patients’ mental health can contribute to their physical health will go a long way in preventing readmissions, improving patient satisfaction, and enhancing overall quality of care.
Case Management Monthly will cover this topic in more detail in the April issue.
Case managers doing more with less as the economy falters
It should come as no surprise that case management–a profession borne from the need to combine quality patient care and effective cost management–finds itself on the front line of the our nation’s financial crisis. Healthcare facilities across the country are seeing their financial resources under assault in a multitude of ways, including significant reductions in state and federal funding for Medicaid and Medicare reimbursement, declining endowments and donor contributions, and increases in charitable care. [more]
