tag:blogger.com,1999:blog-9181810725696409953.post3769120023828347683..comments2024-03-17T04:20:11.083-04:00Comments on The Population Health Blog: Disease Management for Severe Mental IllnessJaan Sidorovhttp://www.blogger.com/profile/05072456803925863874noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-9181810725696409953.post-67739867051633098012008-12-17T09:19:00.000-05:002008-12-17T09:19:00.000-05:00Exactly...that is the operational challenge! The ...Exactly...that is the operational challenge! The medical home will have to have equal representation for medical/behavioral or have behavioral a seamless part of home. Looking at and looking for practices that fit the bill or are interested in build out to fit the bill. So FQHCs and large vertically integrated systems with solid behavioral health divisions are the first place we are looking.Unknownhttps://www.blogger.com/profile/18413853478946732054noreply@blogger.comtag:blogger.com,1999:blog-9181810725696409953.post-42120130911750129842008-12-17T09:01:00.000-05:002008-12-17T09:01:00.000-05:00Makes me wonder if the diagnosis of schizophrenia ...Makes me wonder if the diagnosis of schizophrenia regularly warrants its own disease management program. Concurrent illnesses like diabetes, hypertension etc can be addressed as part of the plan of care, but the point is that the mental illness gets the priority attention. I'm not sure the primary care 'medical home' is operationally configured to manage this. I'd aim for getting a 'responsible provider' in place and I'd rely on nurses/coaches with a background in mental health....Jaan Sidorovhttps://www.blogger.com/profile/05072456803925863874noreply@blogger.comtag:blogger.com,1999:blog-9181810725696409953.post-30778291264601679972008-12-17T08:38:00.000-05:002008-12-17T08:38:00.000-05:00The most significant behavioral health issue in th...The most significant behavioral health issue in the population I have reviewed is schizophrenia- with this diagnosis being the major driver of illness burden and the accompanying poor adherence re the medical co-morbidities. So for example, within the 50% co-morbid for medical and behavior, I can see well over half carrying a diagnosis of schizophrenia (this is based on claims data, so some caution is advised regarding accuracy of the dx). I am wrestling with the operational, contracting, and other myriad issues that accompany establishing a "medical home" to address the medical/ behavioral issues of this population in an integrated fashion....one stop shopping- a good idea but a very steep hill to climb particularly with the challenging issues that this population presents.Unknownhttps://www.blogger.com/profile/18413853478946732054noreply@blogger.comtag:blogger.com,1999:blog-9181810725696409953.post-19719060169442482832008-12-17T06:44:00.000-05:002008-12-17T06:44:00.000-05:00Interesting thought, Charles. What are the behavi...Interesting thought, Charles. What are the behavioral 'co-morbidities' in this population, other than drug, alcohol and tobacco abuse?Jaan Sidorovhttps://www.blogger.com/profile/05072456803925863874noreply@blogger.comtag:blogger.com,1999:blog-9181810725696409953.post-14977936656327936762008-12-11T09:26:00.000-05:002008-12-11T09:26:00.000-05:00Good for you for highlighting behavioral health DM...Good for you for highlighting behavioral health DM. We are finding in Medicaid population that the chronic, complex medical DM patient carries a 50% co-morbidity for behavioral health dx. Numbers on over one million members! I think the key to DM, and not just behavioral health DM, is addressing the behavioral health comorbidities; this is particularly true in Medicaid. We are doing aggressive field DM with this population with notable success- using field because population is so hard to reach via telephone. Charles GrossUnknownhttps://www.blogger.com/profile/18413853478946732054noreply@blogger.com