KHC Fifth Annual Conference to Focus on High Value Behavioral Healthcare

On March 5, the KHC’s annual conference will move from a broad based view of value-based healthcare innovation to a deep dive into what many would say is Kentucky’s most important healthcare priority – behavioral healthcare. This conference will examine how employers, payers, and providers can ensure individuals have access to timely, appropriate mental health services and treatment, through the latest advancements in value-based behavioral healthcare.

Mental health and substance use disorder continues to rise to the top of many healthcare purchasers’ costliest and most prevalent conditions. Yet, these conditions are not treated by plans and providers the same way as physical health conditions. In fact, mental health is the only chronic disease in America that is not treated until Stage IV. And individuals facing substance use disorder continue to receive treatment that does not comply with current medical recommendations. Research consistently demonstrates smaller payments to behavioral health providers and higher out-of-network use for patients with mental health and substance use disorders, despite parity being law. All of these barriers create a system that often does not meet individuals’ behavioral healthcare needs.

The night before the conference a networking reception will be held, during which a short role-playing exercise by local high school students and a psychologist will demonstrate to attendees how adults and students can have positive mental health dialogue. Appetizers and drinks will be served, and exhibitors will be available.

The morning of the annual conference will kick off with Paul Gionfriddo, President and CEO of Mental Health America. Gionfriddo will provide an overview of mental health status and access in the United States, with a personal reflection on how, through policy decisions, he helped create a flawed mental health system that has failed millions, including his son.

Dr. Stephen O’Connor, University of Louisville Department of Psychiatry and Behavioral Sciences, will moderate four panelists, who will discuss several drivers and contributors to poor mental health often overlooked:

  • Dr. Joseph Bargione, a school psychologist, will discuss how healthcare networks can address adverse childhood experiences (ACEs) in patients
  • Dr. Danesh Mazloomost, anesthesiologist and pain management specialist, will discuss a new framework for treating pain that avoids addiction and has better outcomes
  • Aja Barber from Louisville Metro’s Center for Health Equity will explain how the relationship between mental health, social determinants of health, and institutionalized systems of power/oppression keep us from experiencing the kind of world we all deserve
  • Allison Tu, StAMINA and student at duPont Manual High School, will share youth insights into the factors influencing mental health from a series of focus groups conducted with high schoolers across Kentucky

Mike Thompson, President and CEO of the National Alliance of Healthcare Purchaser Coalitions, will discuss the roadmap and checklist his organization developed for employers to use in designing high value behavioral healthcare. All attendees will receive a copy of the roadmap, which includes an assessment of current performance of health plans and behavioral health organizations across key areas. The KHC is a member of the National Alliance, which represents more than 50 business coalitions in the U.S., supporting more than 12,000 healthcare purchasers and 45 million Americans.

A light continues to shine on the fact that many patients do not get appropriate treatment for substance use disorder. As a result, two new payment models have been designed to help incent effective treatment and recovery. Dr. Kelly Clark, an addiction psychiatrist and the President of the American Society of Addiction Medicine, will present the new Patient-Centered Opioid Addiction Treatment (P-COAT). The model is designed to increase the utilization of office-based treatment of opioid use disorder by providing adequate financial support to successfully treat patients and broaden the coordinated delivery of medical, psychological, and social support services. David Smith from Third Horizon Strategies will then discuss the new Addiction Recovery Medical Home (ARMH) receiving significant national attention. The model establishes a continuum of care from the time a patient enters an acute-care setting and is diagnosed with a substance use disorder through their recovery process. ARMH incorporates quality payments and bonuses for achieving certain outcomes and cost savings.

Telehealth has quickly gained the attention of employers and payers working to increase network adequacy of medical and behavioral health providers. Commissioner Jenny Goins will present examples of how Kentucky’s Department of Employee Insurance has implemented telehealth behavioral health along with the data related to utilization and financial savings.

Dr. Diana Han, Global Medical Director for Louisville-based GE Appliances, a Haier company will explore the reactions of local health plans to the day’s presentations. She will discuss with plans how their organizations are innovating to help individuals gain access to timely, effective, and affordable behavioral healthcare. Eric Bailly from Anthem and Dr. Stephen Houghland from Passport Health Plan will discuss their latest strategies to address network adequacy of high quality behavioral health services to their members.

Several other behavioral health innovations will be highlighted at the conference as well. Attendees will learn about a new non-opioid alternative for reducing opioid exposure post-surgery. A new MOMS Partnership that makes mental health within reach of over-burdened, under-resourced mothers will be presented. The KHC will will share the six priority behavioral healthcare measures selected to align Kentucky’s primary care providers and will provide a sneak peek into the soon-to-be released toolkit for employers on benefit design and workplace policies for supporting prevention, treatment, and recovery.

The conference will provide excellent networking opportunities for all types of healthcare stakeholders. Over 20 exhibitors will be available to discuss their latest products and services. If you have any questions about the conference, be sure to call the KHC office at 502-238-3603 or email info@khcollaborative.org. We hope to see you there next month!

Changing the Narrative One Day at a Time

Dr. Ken Wilson, KHC Co-Chair, Retires After Fourteen Years of Esteemed Service and Leadership

KHC Releases 2018 Annual Report

Last year was a big one for the KHC, and it marked the beginning of many changes for our organization…

2018 Round-up: Top Stories from the KHC

Two years ago, the KHC launched a blog with the goal of improving communication with our members and the community about KHC activities, partner work, local and national news, and industry updates. In what has become an annual tradition, we are ending 2018 with a “Best of” for our blog, looking at posts that have had the heaviest readership and those that our staff deemed its favorites.

Most Read Posts

  1. Kentucky Core Healthcare Measures Set Finalized. Leading the development of a core set of primary care measures for Kentucky was one of the greatest accomplishments in the KHC’s 15-year history, and readership of the blog post that announced its completion reflected that, making it the highest read post of the year.
  2. High School Students Found Action Group to Improve KY Youth Mental Health. With mental health as a top priority, the KHC began a new collaboration with the Student Alliance for Mental Health Innovation and Action, a network of passionate students driving the movement to improve youth mental health through research and action.
  3. SBIRT: Why Should I Care? This guest post, written by Mallori De-Salle, highlights the need for a fundamental change of thinking around how we view substance use disorders.
  4. SBIRT Toolkit Released for Healthcare Providers to Address Opioid Crisis. In 2018, the KHC developed through a Kentucky Opioid Response Effort grant a guide for primary care providers on Screening, Brief Intervention, and Referral to Treatment (SBIRT), which identifies individuals with risky and unhealthy substance use behaviors.
  5. KY Core Measures Set Now Available for Public Comment. Again reflecting the magnitude of the development of a core set of healthcare measures, a second post on the subject showed up on the most read blog post lists. This piece announced the beginning of a public comment period. The KHC received many thoughtful responses from healthcare stakeholders across the Commonwealth.

KHC Staff Favorites

 

Kentucky Core Healthcare Measures Set Announced and Action items identified on healthcare affordability in the region at the KHC Community Health Forum

Selected by: Randa Deaton

It is always hard to pick a favorite blog post of the year, so this year I’ve decided not to pick just one but rather two of my favorites about the power of collaboration by Stephanie Clouser. The first one is Kentucky Core Healthcare Measures Set Announced, because it is one of the KHC’s greatest accomplishments over its 15 year history. This blog post summarizes the power of collaboration, when many minds and stakeholders come together. My second favorite blog post is her most recent post titled, Action items identified on healthcare affordability in the region at the KHC Community Health Forum. This post describes the KHC’s first candid discussion with multiple healthcare stakeholders about the drivers of healthcare affordability and its impact on our community. The event was comprised of many thought leaders representing payers, purchasers, providers, policymakers, and consumers, and the convergence of ideas indicated a readiness by many of the stakeholders to move toward action. As we look forward to 2019, the KHC will continue to use its platform to promote collaboration to advance the healthcare of our community.

High School Students Found Action Group to Improve KY Youth Mental Health

Selected by: Teresa Couts

My favorite blog came from Allison Tu, a student at duPont Manuel High School. She founded an action group called the Student Alliance for Mental Health Innovation and Action, or StAMINA. StAMINA is a student-driven group on a mission to change the state of student mental health in Kentucky. I find it refreshing that teenagers are focused on serious health challenges that affect their peers. Students are experiencing stress, anxiety, and depression that may go unchecked by parents, family members, and teachers resulting sometimes in suicide. StaMINA’s mission to decrease stigma surrounding mental illness and increase effective mental health prevention and treatment services for Kentucky youth is commendable. I dislike the stereotypes that we put on teenagers, such as, they are on social media all day, only care about themselves, are irresponsible, lazy, up to no good, and too young to understand anything about life. The youth are our future and with groups like StaMINA we are in good hands.

National Alliance Annual Forum Identifies Priority Issues and Key Actions for Employers

Selected by: Michele Ganote

This year was my first to attend the annual National Alliance Forum. It was exciting to be present as KHC was awarded the 2018 Membership Leadership Award for this year’s work on healthcare measurement alignment, youth mental health and opioid use disorder. The conference consisted of some great topics with very knowledgeable speakers. It’s interesting that so many speakers are passionate about what they do because of their own experiences with health and/or healthcare. It’s comforting to know that none of us are alone with what we have experienced in the healthcare world. We can always find someone who can relate. Marc Brackett, PhD, Yale Center for Emotional Intelligence, was one of my favorite speakers. The approach at Yale Center is to focus on the role of emotions and emotional intelligence in learning, decision making, relationship quality, and mental health. His talk was interesting and he presented the information in a way that was fun and relatable.

SBIRT: Why Should I Care?

Selected by: Natalie Middaugh

One of my favorite blog posts of 2018 was from Mallori DeSalle, Outreach Coordinator and Lead SBIRT Trainer at the Indiana Prevention Resource Center, and guest panelist on our October SBIRT webinar. SBIRT calls for a fundamental change of thinking around how we view substance use disorders, and this post highlights the ease and benefits of making this change. Mallori raises the question, “What if we look at alcohol or substance use as a health behavior that can either increase or decrease our risk for experiencing harm, much like our current views on seat belts?” This comparison emulates the “common sense” nature of SBIRT and helps us envision how an upstream approach to addressing risky substance use behaviors can be critical in avoiding the associated negative outcomes. I have heard resounding enthusiasm around SBIRT implementation, both locally and nationally, and I am hopeful that the KHC can continue serve as catalyst and supporter of its adoption.

QPR Reflections: Suicide Prevention Training Hits Home

Selected by: Stephanie Clouser

This piece was a personal one to me, starting out as a journal entry that morphed into something more. In September, as part of the KHC hosted a Question, Persuade, Refer (QPR) suicide prevention training session as part of a community goal to set a record for people trained in one week. It hit home for me, being in the position myself just last year. The KHC has spent the last year and a half focusing on better integration of mental and physical health, recognizing that not being afraid to have conversations around mental health is a big part of reducing stigma and better addressing the issue in our community. I was grateful for the opportunity to share some of my story and grateful that the work the KHC has done around mental health has made a personal impact on me.

Action items to address healthcare affordability in the region identified at Community Health Forum

It’s no secret that we have a problem with healthcare affordability in this country. Each day, there are new headlines that highlight this problem. We are all familiar with these headlines. But what do we do about it?

That’s exactly what we addressed in last week’s Community Health Forum, “The Path to Affordable Healthcare.” In a different format from our typical Community Health Forum, which lasts a couple of hours, “The Path to Affordable Healthcare” was extended to a half-day event and included an interactive portion, where participants worked in groups to create action items to tackle healthcare affordability in the region.

FORUM INVOLVED LEARNING AND TAKING ACTION

In the first half of the day, participants listened to several speakers and panelists discuss the lack of agreement on an affordability definition, the current state of healthcare affordability in the nation and region, the drivers of healthcare affordability, the role of regional collaboration, and the barriers that keep us from achieving affordable healthcare.

There was much interesting information given and discussion had in first half of the day, including three speaker presentations and a panel loaded with healthcare experts from across the Commonwealth (see agenda here). But the highlight of the day was the creation of action items by event participants designed to help develop a community action plan to address healthcare affordability in our community.

“For me the event just reconfirmed how pivotal the KHC is to the region. Having healthcare stakeholders (purchasers, payers, hospitals, and so on) all working to together to understand each other’s needs is the only way we are going to get true change to a fragmented system. Everyone will win when our healthcare systems provide quality care, access to care at an affordable cost. Alone we can accomplish nothing. Working together we can gain everything.” -DeAnna Hall, Manager Corporate Health & Wellness, LG&E KU

Working in groups, participants brainstormed and defined goals to prioritize and improve healthcare affordability as it relates to health, price, and waste – the drivers of healthcare affordability. The action items were not limited to what the KHC could accomplish, but for the community as a whole. Given the range of viewpoints in the room, the task became an energetic exercise. Ten ideas were identified and discussed with the larger group, and participants then identified and voted on their top three selections.

The action items were outlined, in descending order of votes:

1. Create a state-wide data warehouse with claims, electronic health records, and public health data to map price and quality variation. The warehouse will be led by the state and the KHC and the data will be used to partner with the next iteration of the RAND hospital price transparency study.

2. Create a statewide collaboration to identify the top three costly chronic conditions that have a gap in care and work to close gaps through payment innovation, patient education, aligned cost and quality measures, and care coordination.

3. Participate in a self-insured transparency study for Kentucky with the current iteration of the RAND hospital price transparency study and use the results of the study in next year’s contract negotiations.

4. Conduct a three-year pilot to create a workflow redesign to integrate social determinants of health, physical health, and mental health into a quality patient care management plan in Louisville Metro.

5. Create a knowledge transfer center for employers and health plans to define health transparency and value-based purchasing, to be operated by the KHC.

6. Promote competition and consumerism to drive affordability through legislation. Educate legislators on price transparency.

7. Promote healthcare transparency and affordability across all parties by removing data barriers.

8. Improve patient engagement with health coaches or community health workers, with a focus on preventive screening in rural areas of Kentucky.

9. Create a defined pathway for musculoskeletal outcomes pricing with reduction in imaging for low back pain. Each year, focus on specific employers.

10. Educate consumers, employers, students, etc., on healthcare benefit literacy.

“Active engagement, interaction, and partnership among government, payors, employers, and providers is essential to solving the dilemma of healthcare affordability in Kentucky. While we all share a common objective to provide high quality care to the citizens of the Commonwealth, we need to start four-way conversations to listen and understand perspectives and challenges and then use this information to create productive solutions. In our workgroup I believe each member learned something new about another’s perspective. As a first-time participant I look forward to opportunities for further engagement to offer a providers perspective and contribute to real problem solving.” -David Zimba, Managing Director, Kentucky Health Collaborative, and event panelist

NEXT STEPS

There is a clear want and need for better data around cost and quality in the Commonwealth. As the KHC data scientist, this is what I like to hear! It is impossible for any stakeholder – consumer, provider, plan, or other – to make informed and appropriate choices with large gaps in information. Transparency is key to healthcare affordability, as it provides insights and identifies problems. There was also a lot of talk around minimizing wasteful treatments and procedures that provide little or no benefit.

Many potential ideas were created at “The Path to Affordable Healthcare,” and the next step is to identify which can be and should be acted upon in the community. This event was held in partnership with the Network for Regional Healthcare Improvement (NRHI) to bring healthcare affordability to the forefront of healthcare transformation efforts through a campaign called Affordable Care Together. As part of that campaign, the KHC is required to create an action plan by January 15.

The KHC will take these action items back to its leadership team to determine which are appropriate for our organization to pursue. Look for more updates in the near future.

National Alliance Annual Forum Identifies Priority Issues and Key Actions for Employers

On November 12, the Kentuckiana Health Collaborative team ventured to our nation’s capital to attend the National Alliance of Healthcare Purchaser Coalition’s Annual Forum, “Leading the Future of Innovation, Health, and Value.” The forum brought together 427 representatives from employers, employer coalitions, and thought leaders in healthcare. Spread over three days, the forum featured numerous engaging speakers, panelists, innovators, and champions to highlight the employers’ role in improving health and healthcare quality for both their employees and their communities.

The first day of the forum focused on bringing together speakers from across the healthcare spectrum to share their insights on critical issues facing our nation. Afternoon workshops focused on topics of benefit design, obesity, the opioid crisis, and mental health, with conference attendees having their choice of attending two of the four workshops. A highlight of these workshops was the “Achieving Peak Performance: The Mental Health Difference.” This workshop focused helping organizations becoming more successful in implementing a value-based approach to mental health, using the National Alliance’s Mental Health Deep Dive Report as a guide. With only an hour and forty-five minutes allotted for the discussion, Mike Thompson, CEO of the National Alliance of Healthcare Purchaser Coalitions, entered the room to alert us that we had extended well past our session’s intended time. He exclaimed his pleasant surprise at having to interrupt a conversation about mental health among employers in a room that had become standing-room only. The enthusiasm for this topic among employers was evident, and it was clear that the KHC was not alone in prioritizing mental health among its organizational initiatives. The day was concluded with a panel of purchasers who are leading the way in improving healthcare value to share their innovative ideas, successes, and failures, including Walmart, General Dynamics Bath Iron Works, Miami Dade School District, American Speech-Language-Hearing Association, and Prudential.

Day two of the forum was kicked off with an engaging keynote from Dr. Ezekiel Emanuel, Vice Provost for Global Initiatives and Chair of the Department for Medical Ethics and Health Policy at the University of Pennsylvania, where he shared his insights on opportunities for healthcare transformation. He identified three pieces of advice for healthcare purchasers: (1) reaffirm the primary care relationship, (2) move to alternative payment models, and (3) choose quality metrics for quality reporting. A panel of journalists from leading healthcare news outlets followed Dr. Emanuel’s presentation, giving context to his advice with a discussion on the impact of midterm elections on healthcare reform efforts and innovations, and their  perspectives on the possibilities and perils that may be to come. Afternoon breakout sessions highlighted innovations in specialty drugs, bariatric surgery, stress, PBMs, organizational culture of health, onsite clinics, and biosimilars. During lunch, the National Alliance held a ceremony for their 2018 award recipients. The Kentuckiana Health Collaborative was honored to receive the 2018 Membership Leadership Award along with the Florida Health Care Coalition. Walmart received the 2018 Employer/Purchaser Excellence award.

The third and final day of the annual forum ended on a high note. A morning presentation from Dr. Christa-Marie Singleton on the CDC’s Total Worker Health initiative highlighted their six high-burden health conditions & six ways to spend smarter. Shifting back to mental health, Craig Kramer, Global Mental Health Ambassador at Johnson & Johnson, spoke of his own family’s experience with facing and overcoming a mental health challenge and how it motivated him to take action within his company. Marc Brackett, PhD, Director of the Yale Center for Emotional Intelligence gave a professionally and personally enriching conversation on the concept of emotional intelligence and its impact on the workplace.

The Kentuckiana Health Collaborative’s work surrounding mental health, substance use, healthcare quality, and affordability align closely with the national priorities being set forth by the National Alliance and other employer coalitions. The Annual Forum provided the KHC team with excellent context and tools that will help us move our initiatives forward for the benefit of our local, state, and national communities. The KHC looks forward to sharing all that we have learned with our members and partners. Visit our Twitter page to view additional insights from the forum.

Kentuckiana Health Collaborative Nationally Recognized for Leadership Efforts

The Kentuckiana Health Collaborative (KHC) was recognized along with the Florida Health Care Coalition as the 2018 Membership Leadership Award winner at last week’s National Alliance of Healthcare Purchaser Coalitions (National Alliance) annual forum. The coalitions were celebrated for efforts to improve quality and efficiency of the healthcare delivery system. Several members of the KHC attended the event in Washington, D.C. KHC Co-Directors, Dr. Teresa Couts and Randa Deaton, accepted the award and thanked the staff, members, and community for coming together to make these accomplishments possible. The National Alliance released a press release for the recognition.

The KHC was recognized for its work to improve healthcare measurement alignment, youth mental health, and opioid use disorder risk assessment.  The KHC and the Kentucky Department for Medicaid Services joined forces on the Kentucky Core Healthcare Measures Set, a public-private effort to create a common primary care measures set in the Commonwealth of Kentucky to improve the quality and value of care, reduce provider reporting complexity and align Kentucky’s healthcare measurement. Additionally, the National Alliance recognized the KHC for its mental health work with the Kentucky Cabinet of Health and Family Services Department of Behavioral Health to assist primary health care providers in implementing screening, brief intervention, and referral to treatment (SBIRT) into their practices and its partnership with StAMINA (Student Alliance for Mental Health Innovation and Action) to improve youth mental health.

The National Alliance of Healthcare Purchaser Coalitions is a nonprofit network of business coalitions, representing more than 12,000 purchasers and 45 million Americans, spending more than $300 billion annually on healthcare. The National Alliance is dedicated to driving innovation, health, and value along with its coalition members through the collective action of public and private purchasers. To learn more, visit nationalalliancehealth.org.

NAMI Louisville Works to Address Challenges of a Nation on the Brink of a Mental Health Crisis

(Note: this guest post was written by Nancy Brooks, Executive Director, National Alliance on Mental Illness (NAMI) Louisville)

I joined NAMI Louisville as their new Executive Director this time last year. I have had a rich non-profit management history in education, the arts and community development, but working with NAMI Louisville, I am being given the opportunity to make a difference in an area that greatly needs support. NAMI Louisville is working tirelessly to meet the very real challenges of a nation on the brink of a mental health crisis.

Never before have so many people been in need of mental health resources. Never before has the co-occurrence of substance abuse and addiction alongside mental illness been so critical. Never before has our nation seen such sad statistics associated with suicide. And never before have our children needed more support in their mental health.

NAMI Louisville, the local affiliate of the National Alliance on Mental Illness, has a mission to strengthen families and individuals affected by mental illness through education, support, and advocacy. We provide regular FREE educational classes and support groups for family, friends, and caregivers of those affected by mental health conditions, as well as support groups for individuals who are in recovery from their illness. We advocate at the local, state, and national levels to bring better funding and resources to those who need care. We are working to bring programming to those in our underserved West End and to our outlying counties, including those in Southern Indiana. We are rolling out new cutting edge programming for the workplace, for veterans, for those for whom English is a second language, and for the youth of our community, a group VERY much in need of our services.

Present statistics are bleak! One in five people will be affected by some form of mental health condition in any given year. Worse yet, suicide is now the second leading cause of death in children ages nine to 22. Mental Illness in youth is on the rise with substance abuse, self-harm and eating disorders rapidly increasing. These statistics alone are frightening, but often there is a 10-year delay in youth between the onset of their mental health condition and their finding a proper diagnosis. These children will be 50% more likely to drop out of high school, and 70% of our incarcerated youth have an underlying mental health condition.

NAMI is working to end the stigma associated with mental illness. We partner with healthcare providers, schools, businesses, government officials, community and church leaders, and more in an effort to bring awareness, resources, education, and support to the Kentuckiana community. More information on NAMI Louisville can be found on our website or by calling our office at (502) 588-2008. We are always in need of volunteers, community partners, and financial support.