EVALUATION OF THE INLAND EMPIRE HEALTH PLAN (IEHP) BEHAVIORAL HEALTH INTEGRATION INITIATIVE (BHI-I) UCSD and USC

Evaluation Team  Todd Gilmer, UCSD  Kimberly Center, UCSD  Amy Panczakiewicz, UCSD  Ben Henwood, USC  Harder & Co, Inc.  Sagacious Consultants

Goals of BHI-I Evaluation  The goal of BHI-I evaluation are:  To describe the implementation of integrated care and complex care management  To provide feedback to programs and BHI-I teams  The BHI-I evaluation will measure the extent to which the initiative:  Improves health outcomes  Increases integration of physical health, mental health, and substance use treatment  Increases complex care and population care management

Technical Reporting at Learning Sessions Reporting Elements  Technical reports  Report on implementation overall and at the program level  Dashboard report of primary outcomes  Qualitative report of patients’ experience  Study status reports  Report on BHI-I teams’ progress using the roadmap  Fact sheets

Data Supporting the Technical Reports  Individual level health outcomes  PROMIS Global Health Scale  Individual level behavioral health outcomes  PHQ9, DLA20  Individual level physical health clinical indicators  BP, LDL, A1c  Program level quality metrics  HEDIS scores  Program level illness severity  ACG case-mix

PROMIS Global Health Scale  10 Items measuring three domains  Physical health  Mental health  Social health  Provides an overall health score and domain scores  Provides a Quality of Life score to be used in the cost-effectiveness analysis

Dashboard Display of Key Indicators  % of caseload active  % of active caseload screened  Behavioral health  Physical health  % of active caseload not at goal at baseline who are currently achieving goals  Behavioral health  Physical health

Describing Patients’ Experiences  Qualitative study of patients’ experiences  Patients will interviewed during site visits  Goals include:  Telling their stories / providing a voice  Providing a depth of information on program effectiveness  Identifying strengths as well as barriers / weaknesses

Measuring BHI Progress - Roadmap  Engage leadership  Identify and adopt a quality improvement methodology and tools  Program design and sustainability planning  Build the multidisciplinary complex care team  Enhance engagement of individuals and providers  Offer integrated care and complex care management  Sustain health homes

Measuring Integration  Surveys measuring integration and complex care management will be administered to BHI-I teams at baseline and 12 month follow up  Adaptation of the Maine Health Access Foundation Site Self-Assessment (MeHAF-SSA)  Site visits will be conducted to assess progress in the BHI-I domains  Provider Engagement and Satisfaction Surveys

Integration and Cost Reports Reporting Elements  Integration and complex care reports  Common themes, successful strategies, barriers, and challenges at baseline  Site visit findings  Cost-Analysis reports  Utilization and cost of inpatient, ER, outpatient and pharmacy services  Cost-effectiveness using the PROMIS Global Health to calculate the incremental cost effectiveness ratio (ICER)

Final Reports Report Elements  Final set of biannual reports that includes all outcomes analyzed overall and at the program level  Final report of common themes, successful strategies, barriers, and challenges to implementation of integrated care and complex care management  Final report on cost-effectiveness