Promising Western Colorado SHAPE Results to be Presented at PCPCC Fall Conference: Nearly 5 Percent Lower Total Cost of Care

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Western Colorado pilot demonstrates feasibility of behavioral health integration with global payments

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Eradicating antiquated payment methodologies in support of such clinical integration, like behavioral health, is one of the only ways we are going to see the Triple Aim of improving outcomes, decreasing cost, and enhancing our patients' experience

Addressing the behavioral health needs of patients should be an integral part of providing comprehensive primary care. Too often, it's not. However, a pilot in Western Colorado suggests that, with appropriate payment mechanisms, primary care practices can integrate and sustain behavioral health.

Early results of that pilot will be presented Nov. 12 at a Patient-Centered Primary Care Collaborative Fall Conference session, "Partnerships in Behavioral Health - Models for Addressing Mental Health in Primary Care." Panelists include Patrick Gordon, MPA, associate vice president, Rocky Mountain Health Plans. Benjamin Miller, PsyD, director of The Eugene S. Farley, Jr. Health Policy Center, University of Colorado, will moderate.

Gordon will discuss preliminary cost results from the SHAPE (Sustaining Healthcare Across integrated Primary care Efforts) pilot, an effort to rethink and re-envision the role of behavioral health in primary care and change the way it is reimbursed. Miller served as SHAPE's principal investigator in partnership with the Collaborative Family Healthcare Association; it was funded by the Colorado Health Foundation.

Over the course of the SHAPE demonstration, practices that received global payments from RMHP for integrated care showed a 4.8 percent lower total cost of care for attributed patients, in a normalized comparison with a control group. "We are pleased, but not really surprised by these findings," Gordon said today. "These results are consistent with our own internal analyses of how well advanced primary care sites perform--particularly when they integrate behavioral health." Quality results and all the financial outcomes are expected to be released shortly.

"Eradicating antiquated payment methodologies in support of such clinical integration, like behavioral health, is one of the only ways we are going to see the Triple Aim of improving outcomes, decreasing cost, and enhancing our patients' experience," Miller says. "This is about changing the rules of the game to allow for seamless, unfettered access to behavioral health care in the setting where patients most often present with behavioral health issues."

Participating practices receive a global payment for both primary care and behavioral health services. This moves practices and providers away from the fee-for-service model, and shifts the focus to quality and outcomes instead of volume and encounters.

To learn more about behavioral health integration efforts, read Tear down this wall: Integrating behavioral health and primary care. To learn more about SHAPE, visit sustainingintegratedcare.net.

About Rocky Mountain Health Plans
Founded in 1974 in Grand Junction, Colorado, as an independent, not-for-profit health insurance provider, Rocky Mountain Health Plans uniquely understands the needs of Coloradans. We provide access to affordable, high-quality health care enabling our almost 300,000 members to live longer, healthier lives, while maintaining our mission to put people before profits. Rocky Mountain Health Plans is the only health plan in Colorado to serve every market segment, including individuals, families, employers, Medicare, Medicaid and Child Health Plan Plus beneficiaries. The National Committee for Quality Assurance recently awarded Rocky Mountain Health Plans a "commendable" status for continuously improving the quality of care and services provided to members. For more information, visit rmhp.org or connect with RMHP on social media: @RMHPColorado on Facebook, @RMHP on Twitter, @rmhpColorado on Pinterest and @rmhpcolorado on Instagram.

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Sandy Mau
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