Cost Assessment of Collaborative Healthcare

Shandra Brown Levey, PhD, Clinical PsychologistEmma Gilchrist, MPH, Project Manager

Warren Pettine, Medical StudentUniversity of Colorado Denver Department of Family Medicine

Collaborative Family Healthcare Association 16th Annual ConferenceOctober 16-18, 2014 Washington, DC U.S.A.

Session #F4bSaturday, October 18, 2014

Faculty Disclosure

• We have not had any relevant financial relationships during the past 12 months.

Learning Objectives

At the conclusion of this session, the participant will be able to:

• Describe a novel approach to calculating the cost of integration.

• Discuss the benefits of a multidisciplinary team in developing integrated care initiatives.

• Identify the policy implications of assessing cost for integrated care.

Bibliography / Reference

1. Chapkoa MK, Liu CF, Perkins M, Li YF, Fortney JC, Maciejewski ML. Equivalence of two healthcare costing methods: bottom-up and top-down. Health Econ. 2009; 18: 1188–1201

2. James BC, Savitz LA. How Intermountain trimmed health care costs through robust quality improvement efforts. Health Affairs. 2011;30(6):1185-1191.

3. Kaplan RS, Porter ME. How to solve the cost crisis in health care. Harvard Business Review. 2011

4. Katon W, Russo J, Lin EH, et al. Cost-effectiveness of a multicondition collaborative care intervention: a randomized controlled trial. Archives of general psychiatry. 2012;69(5):506-514.

5. Manderscheid RW, Alexandre P, Everett A, Leaf P, Zablotsky B, Eaton W. American mental health services: perspective through care patterns for 100 adults, with aggregate facility, service, and cost estimates. Public mental health. 2012:381.

6. Porter ME. What is value in health care? New England Journal of Medicine. 2010;363(26):2477-2481.

7. Ritzwoller DP, Sukhanova A, Gaglio B, Glasgow RE. Costing behavioral interventions: a practical guide to enhance translation. Ann Behav Med. Apr 2009;37(2):218-227.

Learning Assessment

• A learning assessment is required for CE credit.

• A question and answer period will be conducted at the end of this presentation.

CoACH Origins

• Prescription for Health/ACT/SHAPE• Work with practices to determine the cost of integrating

to determine a global payment• CoACH automates this process and provide a tool for

interested practices to determine financial factors and workflow associated with integration activities

Developed by multidisciplinary team

– Psychology– Public Health– Economics– Actuarial Science– Biostatistics– Integrated Primary Care Practices

• Input from primary care providers, behavioral health providers, practice managers, medical assistants, front desk staff, CFOs, administrators

CoACH: Cost Assessment of Collaborative Healthcare

• On-line tool to determine the estimated incremental expenditure of integrating behavioral health and primary care.

• Practices are asked to work with others in their organization for improved accuracy of estimates.

• Practices receive:• an estimated incremental expenditure to complete the

work proposed• the building blocks for an accurate and adjustable workflow• average reimbursed amounts across payer types based on

the Colorado APCD data by month and year

Some information CoACH requires

• Payer mix percentages by practice• Estimations for FTE of involved personnel• Average monthly mid-point salaries and benefits• Number of patients in the practice• Types of collaborative or integrated care

activities the practice currently does or plans to do

• Estimated time per week providers and staff participate in integrated care activities

Tips for Completing CoACH

• CoACH can be paused and returned to using a link sent to the email address practices provide.

• Working with a team to complete CoACH can help improve accuracy input regarding integration activities, personnel responsible for activities, and activity time approximations.

Policy Implications

• All participants in the health care system need objective, evidence-based information to make critical decisions about how to allocate health care resources.o Employerso Insurerso Patientso Providerso State Policymakerso Federal Policymakers

Session Evaluation

Please complete and return theevaluation form to the classroom

monitor before leaving this session.

Thank you!