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Ascension maps plan for expanding behavioral health

February 15, 2017

By JULIE MINDA

Ascension will expand behavioral health services in every market where it operates, and it is setting out to incorporate behavioral health care more comprehensively into its work in population health management.

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Trupiano

That is according to Gayle Trupiano, Ascension Healthcare vice president of performance excellence, and Carol Hartmann, director of behavioral and mental health for the St. Louis-based system. The two said Ascension has developed a vision for a systemwide enhancement of behavioral health services over the next three to five years.

Hartmann said Ascension will be on the leading edge of a trend in behavioral health care toward "using new, creative models for assessing mental health care in all kinds of settings — including primary and specialty care — and extending clinically integrated systems of care to ensure appropriate care for patients at every level" of the organization. She said, "We have an opportunity here to look at the best and most effective practices so we can deliver quality mental health care in all our settings."

The new systemwide focus is based on Ascension's "recognition that to have good health, you need to include good mental health," she said.

Opening doors to services
Plans call for Ascension Healthcare, which is Ascension's health care division, to assess current behavioral health care offerings across the system's 141 hospitals, at its estimated 2,500 outpatient facilities and at its 30 long-term care sites. Planners then will determine where the gaps are and what is needed to fill those gaps.

The focus will be on standardizing best practices across the system, ensuring mental health clinicians and services are embedded into more primary care practices, increasing mental health screening in primary care settings, expanding tele-health services and making sure mental health care is incorporated into population health management work, according to Trupiano and Hartmann.

Ascension operates in 24 states and the District of Columbia. Trupiano said currently behavioral health offerings vary widely from market to market. Some markets have a full continuum of behavioral health care services including inpatient, outpatient and residential care, some have just tele-behavioral health services and others fall somewhere in between.

Trupiano and Hartmann said it is too early to say exactly what Ascension will do in each market and how much the enhancements will cost. Improvements could include recruiting and hiring additional mental health professionals, making facility renovations, adding inpatient mental health beds, extending tele-mental health services and partnering with other organizations in the market. It also is likely that facilities will make use of consumer technology. For instance, smartphone apps may be used to alert patients it's time to take their medications or to remind them of appointments.

Telehealth, population health
Trupiano said given a nationwide shortage of mental health professionals, and with the difficultly of hiring psychiatrists in inpatient settings, the telehealth component of the new vision will be especially important. Last year, Ascension deployed tele-behavioral health service to 40 of its hospitals, giving clinicians quick access to remote behavioral health specialty care for their patients. The service was implemented in emergency departments, urgent care centers and primary care offices. Plans call for an expansion of that service, including potentially to long-term care sites.

Hartmann said Ascension is incorporating behavioral health services into its population health management work. "The population health tie-in is essentially the belief that caring for (people) both physically and emotionally — as well as spiritually — will foster better health outcomes. We understand that many chronic diseases such as diabetes, asthma and obesity, to name a few, may have a behavioral health connection. It's critical to attend to all aspects from a holistic approach," she said.

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Hartmann

She gave two examples of how behavioral health is being used in population health management. Ascension's Alexian Brothers Health System is a provider in the AMITA Health Accountable Care Organization. That accountable care organization employs a behavioral health navigator to direct patients to mental health services. And physicians in Ascension's Tulsa market have embedded a social worker in their practice who focuses on patients' mental health needs. Hartmann said, "These primary care physicians recognize the need for a mental health intervention."

Mental health advocacy
The behavioral health initiative also involves legislative advocacy work, including to build lawmakers' awareness of the value of mental health care and the need for better reimbursement, according to Trupiano.

Trupiano said the amplified approach to behavioral health will benefit some of the most vulnerable people Ascension facilities serve. Plans call for Ascension markets to incorporate behavioral health more intentionally into their response when they treat patients who are homeless. The system will do the same when treating veterans.

Hartmann said clinicians she's talked with throughout Ascension facilities recognize how critically important mental health is to physical health. "We have a lot of motivation and enthusiasm from our providers," Hartmann said.

Ascension invests $20 million in behavioral health triage center

St. Louis-based Ascension is contributing $20 million over the next 10 years to a behavioral health center in Kansas City, Mo. The health system helped to develop and is providing funding for the Kansas City Assessment and Triage Center to improve behavioral health services and divert people with mental health concerns away from jails and emergency rooms.

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Ragone

The 24-hour center, which opened in November, provides people with behavioral health needs a "safe place where they can be assessed, stabilized and referred to behavioral health outpatient or residential services," according to a press release from Ascension. Nick Ragone, Ascension chief marketing and communications officer, said in that release that the triage center furthers Ascension's broader behavioral health strategy by providing "holistic care that treats the whole person — body, mind and spirit." He said this concept undergirds the work of the center.

The triage center is a partnership with Kansas City. The Missouri Department of Health and Senior Services will run the center.

According to information from the Kansas City Business Journal, Ascension will donate $2 million annually over the next decade to fund the center's operations. Other Kansas City hospitals and foundations will provide an additional $1 million annually. The Missouri health department owned the building that now houses the center — it was vacant prior to its renovation.

The business journal says the center's inception is a result of an agreement connected with Ascension's sale of two facilities in 2015. The health system sold its St. Joseph Medical Center in Kansas City and St. Mary's Medical Center in Blue Springs, Mo., to Prime Healthcare Services. The two facilities had been part of Ascension's Carondelet Health system. Three long-term care facilities that were part of Carondelet and the hospitals' foundations remain part of Ascension.

Proceeds from the hospitals' sale helped to fund the new triage center. According to information from Ascension, the

$20 million that Ascension is contributing to the triage center does not represent the total proceeds of the sale.

— JULIE MINDA

 

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