Behavioral Health Solutions for Integrated Health Care & Chronic Disease Management

What is Diet and exercise programs are failing to contain a health epidemic Obesity (BMI >30) presently affects 40% of the US adult population (1/3). The prevalence of obesity has increased by 15% in just 20 years (1/5 > 1/3) 7 of every ten adults are overweight – projected to rise to 9 /10 by 2050 Obesity accounts for 22% of annual medical spending in the US; (197 Billion) – expected to rise to approximately 800 billion by 2030. 20% of America’s children suffer from obesity Rapid escalation in the incidence rate for Type II diabetes

What If ? There’s a program that helps patients adhere to treatment recommendations and increases their motivation to recover from obesity, diabetes, and other debilitating conditions. This program provides transparency of care, resource allocation and helps patients appreciate the depth & scope of multimodal team-care. Rural access and participation in wellness models of care increases and there are qualitative and quantitative gains in patient perception of care. WA providers can provide fully integrated care in accordance with the State Health Care Innovation Plan well ahead of FY 2020. Behavioral health treatment moves toward cost-effective and cost-contained models and standardized assessment data (health & mental wellness) is collected to inform, modify, and improve treatment protocols.

Quick Review: Washington’s Health Care Innovation Initiatives Washington’s drive toward transformation is predicated on three primary drivers—or strategies: Improve health overall by building healthy communities and people through prevention and early mitigation of disease throughout the life course. Improve chronic illness care through better integration of care and social supports, particularly for individuals with physical and behavioral co-morbidities. Drive value-based treatment across the community

Guiding Principles (WA State) Improve health equity: Reduce health and health care disparities by ensuring equal access to limited high-quality resources Encourage individual responsibility for maintaining and improving health Provide resources and structure for greater accountability Acknowledge and overcome delivery challenges and opportunities in different geographic areas and for different population subgroups. Utilize resource guided and supported e-learning and tele-health for rural or underserved communities and those with disabilities

BreakThrough! supports WA State Principles Treatment expectations are transparent to providers, participants and Insurance companies (Foundation Principles 1 & 4) Program structure increases accountability for participants to ensure adherence to treatment goals ahead of costly (gastric) surgeries (Foundation Principle 2) BreakThrough programs are designed to integrate evidence-based behavioral health care into the treatment of chronic illness across all communities (IWMT) (Foundation Principle 3) BreakThrough promotes cost-effective utilization of human resources while maintaining and/or improving health outcomes through data collection (Foundation Principle 5) The BreakThrough programs present structured behavioral health programs for efficient and strategic primary care. (Principle 7).

BreakThrough! Program Overview BreakThrough! is designed as a guided individual or group intervention Participants attend 12 sessions over four months Topics and skills are introduced progressively throughout the course Patients receive a 300 page course manual with written exercises integrated into every chapter/session Modular design allows for resequencing or open groups if necessary Program materials are updated to reflect emerging research and best practices Cost – determined by provider, facility size, etc.

Target Population Individuals diagnosed with co-occurring (or emerging) weight and mental health challenges. For example a dx of Metabolic Disorder and: Depression Anxiety Trauma disorder Personality issues Addiction Eating Disorder

Social Context Breakthrough! also addresses important social and relationship dynamics that affect our mental and physical well-being Primary Relationships Family dynamics & attachment style(s) Social environment Workplace Community Social Media

Market importance BreakThrough! fully complements and support existing weight loss programs and medical interventions (such as bariatric sx) that focus primarily on diet, medication, and exercise BreakThrough! is a fully operational program easily implemented and led by professionals across the broad spectrum of medical and mental health care settings BreakThrough! requires nominal up-front expenditure and resources BreakThrough! relies entirely on evidence-based practices and principles drawn from current peer-reviewed research BreakThrough standardizes targeted mental health care

Course Resources BreakThrough! Manual / Workbook for each participant Breakthrough! Daily Reflection BreakThrough! Instructor resources Environment that provides adequate and comfortable seating for intended group size (ADA compliant) A sense of humor Web access for course support and presentations (optimal) (Computer Based Guided e-learning in development)

4-Month Integrated Care Program Obesity – current tech BMI>25-30 Intake WK 1 WK 2 WK 3   WK 4 WK 5 WK 6 WK 7 WK 8 WK 9 WK 10 WK 11 WK 12 Units MD 0.5 0.25 1 ARNP .5 2 Therapist  1 1  13 Nutritionist 1* 3 Group Med Asst E-Learn Admin 5 Weekly Totals 4 4.5 4.25 3.5 4.75 55

4-Month Integrated Care Program Obesity – group model BMI>25-30 Intake WK 1 WK 2 WK 3   WK 4 WK 5 WK 6 WK 7 WK 8 WK 9 WK 10 WK 11 WK 12 Units MD 0.5 0.25 1 ARNP ,5 2 Therapist 5 Nutritionist 1* 3 Group 1.5 19.5 Med Asst E-Learn 16 Admin Weekly Totals 4 4.5 4.25 3.5 4.75 55

4-Month Integrated Care Program Obesity – E-learn BMI>25-30 Intake WK 1 WK 2 WK 3   WK 4 WK 5 WK 6 WK 7 WK 8 WK 9 WK 10 WK 11 WK 12 Units MD 0.5 0.25 1 ARNP ,5 2 Therapist 5 Nutritionist 1* 3 Group Med Asst E-Learn 1.5 18 Admin Weekly Totals 4 4.5 4.25 3.5 4.75 55

Resource Hours

Provider Projected Program Cost - current

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