Des Moines, Iowa — Magellan Health Services, Inc., has announced an innovative new program in Iowa to create “integrated health homes” for people with serious mental illness. The program closely links behavioral and physical health providers to create a more holistic approach to improve the quality of care and lower the costs of treating Medicaid-eligible Iowans diagnosed with a serious mental illness.
A collaboration between Magellan Behavioral Care of Iowa, the Iowa Medicaid Enterprise (IME)/Department of Human Services (DHS), behavioral health agencies and federally qualified health centers, the program focuses on coordinating behavioral and physical health care with the goal of driving better health outcomes in a consumer-focused way.
Behavioral and physical health issues often go hand-in-hand. Research shows that people with a serious mental illness die, on average, 25 years earlier than their peers*. These premature deaths often result from treatable or preventable chronic illnesses, such as diabetes or heart disease, and can be linked to difficulties with access to physical health care and lack of coordination between behavioral and physical health providers.
Behavioral health provider as entry point
While many national health care efforts focus on the physical health care provider as the point of entry for the health home, in the Iowa program, the behavioral health provider serves in this role.
“Behavioral health providers understand the special needs, treatment plans and medications of people with serious mental illness,” said Joan M. Discher, general manager, Magellan Behavioral Care of Iowa. “Iowa’s integrated health home program is unique because medical services are co-located in the behavioral health setting, with behavioral health professionals leading joint treatment teams."
"With this model," Discher added, "we help people with serious mental illness overcome barriers to conventional medical care by meeting them where they are most comfortable—with their behavioral health provider. From there, we can manage their total health needs, closing gaps in care and improving overall clinical outcomes.”
“Whole person” treatment and support
Other key elements of Iowa’s integrated health home program include:
- Customized “whole health” treatment plans focusing on prevention, early intervention and wellness, including coordinated physical and behavioral health case management.
- Treatment guidelines and tools that address the unique needs of those with both serious mental illness and medical conditions.
- Electronic health data to facilitate sharing of behavioral and physical health information among both types of providers.
- Peer support services to encourage the individual’s commitment to recovery and wellness.
- Active coordination between behavioral and physical health providers to help them improve care.
- Community support services and 24-hour access to care.
Four Iowa community providers selected for pilot
Participating behavioral health providers in Iowa include three community mental health centers and one assertive community treatment (ACT) team, who are working together with federally qualified health centers to offer physical health services:
- Abbe Community Mental Health Center in conjunction with Linn Community Care, Cedar Rapids
- Eyerly-Ball Community Mental Health Center in conjunction with Primary Health Care, Des Moines
- Siouxland Community Mental Health Center in conjunction with Siouxland Community Health Center, Sioux City
- Heartland Family Services ACT in conjunction with Council Bluffs Community Health Center, Council Bluffs
These providers responded to a request for proposals from Iowa’s IME/DHS and Magellan. They were awarded community reinvestment funds to support the program based on their commitment to improving care for individuals with serious mental illness and their ability to collaborate with primary care for a ‘whole-person’ treatment orientation.
“We proposed integrated health homes not only for superior care but to control costs,” said Jennifer Vermeer, director, IME. “We expect that the prevention efforts and coordinated services offered through the integrated health home program will yield better total health and quality for individuals – while helping to reduce costs for the state.”
Investing in the community
The integrated health home program is one of a number of projects established by Magellan Behavioral Care of Iowa, with the support and encouragement of the Iowa DHS, using community reinvestment funds. These funds are set aside annually to implement innovative projects that go beyond traditional behavioral health services to benefit Medicaid recipients throughout Iowa.
* Lutterman T, Ganju V, Schacht L, Shaw R, Monihan K, et.al. Sixteen State Study on Mental Health Performance Measures. DHHS Publication No. (SMA) 03-3835. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2003.