Integrated Care in the Real World

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Integrated Care in the Real World presented at the NIDA CTN CTP Caucus Meeting Washington, D.C., March 15, 2011, by John G. Gardin II, Ph.D. Director of Behavioral Health & Research, ADAPT, Inc. Administrator, SouthRiver Community Health Center Clinical Assistant Professor, Oregon Health Sciences University Medical School This project was funded by HRSA/DHHS Rural Health Outreach Grant #1D04RH06903-01.00

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Integrated Care in the Real World. presented at the NIDA CTN CTP Caucus Meeting Washington, D.C., March 15, 2011, by John G. Gardin II, Ph.D. Director of Behavioral Health & Research, ADAPT, Inc. Administrator, SouthRiver Community Health Center - PowerPoint PPT Presentation

Transcript of Integrated Care in the Real World

Page 1: Integrated Care in the Real World

Integrated Care in the Real World

presented at the

NIDA CTN CTP Caucus MeetingWashington, D.C., March 15, 2011, by

John G. Gardin II, Ph.D.Director of Behavioral Health & Research, ADAPT, Inc.Administrator, SouthRiver Community Health Center

Clinical Assistant Professor, Oregon Health Sciences University Medical School

This project was funded by HRSA/DHHS Rural Health Outreach Grant #1D04RH06903-01.00

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ADAPT, Inc.Incorporated in 1971Serving 3 countiesSUD: OPT, Res (adult/adolescent)MH: OPT (adult/adolescent)GamblingCorrections/Drug CourtPreventionPrimary Care +

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HRSA RHO GrantMay 2006-May 2009

To develop an integrated care model situated in free-standing, primary care private practices in Roseburg, Oregon

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Results

Screened approximately 2,000 patients/year (20% of total patients per year)

Providing treatment to about 15%; 50% of these were Medicaid patients

30% of Medicaid patients provided 70% of utilization (“frequent flyers”)

64% showed significant improvement (HADS)

Overall medical utilization by Medicaid patients decreased by 13%

For “frequent flyer” Medicaid patients, decreased medical utilization by 33%

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Overcoming BarriersFull-time co-location of BHC in clinic

Modified SBIrT model

Staffed by LCSW

Establishment of RHC FQHC-LA FQHC?

Adaptation to medical clinic schedule/routine

“Open” cases; brief sessions; available; M&G

Behavioral Medicine billing codes (96150-96155)

Use of EBPs

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What is Working

Medical Assistants

Overbooking - 50% no show rate

Increased appropriate use of psychotropics

15-20 minutes session/brief therapy

Use of Behavioral Medicine Codes

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Continuing Challenges

Training issues with CMAs

Training issues with providers

Schedule challenges

Same-day appointments

Poor penetration of SUD involved patients

eMR and confidentiality

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Dr. John Gardin(541) 672-2691

[email protected]