The Wisconsin Department of Health Services (DHS) has been developing pilot projects to reduce the cost of treating mentally ill Medicaid patients for nearly a year, almost as long as it has taken a for-profit company to build a mental health hospital opening in Green Bay in January 2017.
Gov. Scott Walker (R) signed Senate Bill 293 into law on February 26, 2016, requiring DHS to develop pilot projects to test “alternative, coordinated care delivery and payment models designed to reduce costs of Medical Assistance (MA) recipients who have significant or chronic mental illness,” states a memo by the Wisconsin Legislative Council.
DHS must also establish a pilot project “to test new MA payment models designed to encourage psychiatric consultations by psychiatrists” and engage a company to create a website for tracking mental health bed occupancy in the state, according to the memo.
The law requires health care providers awarded contracts to run the pilot projects to give DHS updates on the projects’ success no later than January 1, 2017, but as of December 2016, only the bed-tracker program was operational, Elizabeth Goodsitt, advanced communications specialist at DHS, told Health Care News.
As DHS continues to plan implementation of the law’s other projects, Strategic Behavior Health, a Tennessee-based hospital system, has been finishing construction of a 72-bed hospital in Green Bay. Willow Creek Behavioral Health Hospital is scheduled to open in January 2017. The facility will serve seniors with dementia and younger people needing psychiatric or substance abuse treatment, the Green Bay Press-Gazette reported in December 2016.
Tracking Participation
Under the law, to be eligible for a $110,000 grant from DHS, the contractor developing the bed-tracker was required to build a system to “enable any hospital emergency department in the state” to view the number of psychiatric beds available by location.
Goodsitt said the bed-tracking system, developed by the Wisconsin Hospital Association (WHA), lets hospitals choose whether their beds will be tracked.
“DHS partnered with the WHA, which developed the database and website under contract with DHS,” Goodsitt said. “As for the number of beds tracked, this a voluntary program, so participating hospitals decide which beds are tracked.
Willow Creek staff did not answer multiple queries regarding whether the hospital’s 72 beds will be trackable by the system.
Claire Yunker, deputy communications director at DHS, says the online database will increase the efficiency of health care providers and accelerate services for patients.
“Currently, inpatient psychiatric units and hospitals must call individual providers to find open psychiatric beds for patients,” Yunker said. “The hope is the online system will reduce the amount of time these health care providers spend on this task by placing up-to-date bed availability information in a secure, searchable database. Patients also will receive the care they need more quickly, resulting in better outcomes.”
Coordinating Care
State Rep. Joe Sanfelippo (R-New Berlin), who serves on the Assembly Committee on Mental Health Reform, says requiring DHS to experiment with coordinated-care delivery models and payment systems encourages a holistic approach to treatment of Medicaid patients.
“We need to encourage collaboration between physical, behavioral, and social services,” Sanfelippo said. “The current system allows for too much segregation in an individual’s health care needs. The result is that we are missing the opportunity to provide preventive care to some individuals who end up utilizing more costly emergency room visits down the road.”
Assessing and treating multiple categories of patient needs each time they visit the doctor will improve quality of care and reduce costs, Sanfelippo says.
“A coordinated effort will help us provide services to people before they enter a crisis situation, which is always better for the individual and less of a financial strain on the program,” Sanfelippo said. “Increasing efficiency allows us to expand our dollars and serve more people.”
Pay Now, Save Later
The law instructs DHS to allocate a state share of $800,000, plus any federal matching funds under Medicaid, for the three-year pilot projects and $110,000 to develop the bed-tracking system.
Sanfelippo says the savings expected from preventing individuals from suffering mental health crises is worth the expense.
“Once a person ends up in a crisis situation, we have already failed them,” Sanfelippo said. “The main objective is to prevent that scenario from happening. The initial upfront investment in preventive care will yield greater savings down the road from reduced reliance on emergency services.”
Lawmakers should increase taxpayer savings by investing in programs likely to cut costs over time, Sanfelippo says.
“We, of course, want to strive for maximum efficiency, but we cannot continue to summarily dismiss some ideas simply because they may have an upfront price tag,” Sanfelippo said.
Marcus Rech ([email protected]) writes from Centerville, Ohio.
Internet Info:
Matthew Glans, “Government Regulations and the Mental Health Shortage,” Research & Commentary, The Heartland Institute, August 24, 2016: https://heartland.org/publications-resources/publications/research–commentary-government-regulations-and-the-mental-health-shortage?source=policybot
Michael T. Hamilton “‘Mental Illness Feels Like’ States Ought to Remove Barriers to Telehealth,” Consumer Power Report, The Heartland Institute, June 2, 2016: https://heartland.org/policybot/index.html?q=%22mental+health%22&fromDate=12-30-2015&toDate=12-30-2016#results
Justin Haskins, “Government Regulations Reduce Access to Mental Health Services,” Consumer Power Report, The Heartland Institute, March 9, 2016: https://heartland.org/news-opinion/news/government-regulations-reduce-access-to-mental-health-services?source=policybot
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