DataBrief: Did you know… DataBrief Series ● February 2013 ● No. 37 Medicare Beneficiaries With Severe Mental Illness and Re- Hospitalization Rates In 2010,

Slides:



Advertisements
Similar presentations
Mental Health is Integral to Overall Health. Health Issues Related to People with Serious Mental Illness People with SMI who receive services in the public.
Advertisements

DataBrief: Did you know… DataBrief Series September 2011 No.17 Differences in Medicare Spending by Disability and Residence Medicare spends almost four.
Context and Overview of Recommended Actions to Reduce Psychiatric Readmissions Michael Trangle, MD Associate Medical Director, Behavioral Health Division.
DataBrief: Did you know… DataBrief Series ● February 2011 ● No. 13 Sources of Long- Term Care Spending Of the $264 billion that the United States spent.
Integrating Care for Medicare- Medicaid Enrollees Medicare-Medicaid Coordination Office Centers for Medicare & Medicaid Services November 2011.
DataBrief: Did you know… DataBrief Series ● February 2011 ● No. 12 Dual Eligibles Across the States In 2008, dual eligibles as a percent of the total Medicare.
DataBrief: Did you know… DataBrief Series ● October 2012 ● No. 34 Residential Care Facilities and Medicaid In 2010, residential care costs for Medicaid.
Donald Mack, M.D. Ohio State University Medical Center Gregg Warshaw, M.D. University of Cincinnati College of Medicine.
DataBrief: Did you know… DataBrief Series ● September 2011 ● No. 16 Residence Setting by Level of Disability Less than 40% of older Americans with moderate.
Bringing Behavioral Health into the Care Continuum: Opportunities to Improve Quality, Costs and Outcomes January 2012.
DataBrief: Did you know… DataBrief Series ● February 2011 ● No. 10 Dual Eligibles – Health Services Utilization In 2008, dual eligibles were 23% more likely.
RTI-UNC EPC Issues Exploration Forum (IEF):. Serious Mental Illness Dan Jonas, MD, MPH.
Health Homes for People with Chronic Conditions: A Discussion with Dr. Moser 10/24/2013Dr. Robert Moser Webinar.
DataBrief: Did you know… DataBrief Series ● March 2012 ● No. 28 Chronic Conditions and Rehospitalizations In 2009, Medicare beneficiaries with 5 or more.
DataBrief: Did you know… DataBrief Series ● December 2010 ● No. 7 Home Modifications 36% of seniors have added a home modification to their living environment?
DataBrief: Did you know… DataBrief Series ● December 2010 ● No. 6 Informal Caregivers Almost 1 in 3 caregivers have been providing care for more than five.
DataBrief: Did you know… DataBrief Series ● January 2012 ● No. 26 Dual Eligibles, Chronic Conditions, and Functional Impairment By Age Group In 2009, 29%
Research and analysis by Avalere Health Are Medicare Patients Getting Sicker? December 2012.
Finger Lakes Health Systems Agency Interface of the Physical and Mental Health Care Systems RCCHI Meeting December 18, 2013.
DataBrief: Did you know… DataBrief Series ● September 2010 ● No. 5 Seniors with Activities of Daily Living Needs Approximately 1 in 4 seniors who live.
The ACA and Medicaid Health Homes Chuck Ingoglia National Council for Community Behavioral Healthcare.
Ronald H. Bradley Addiction Therapy-2014 Chicago, USA August 4 - 6, 2014.
DataBrief: Did you know… DataBrief Series ● February 2011 ● No. 14 Racial/Ethnic Disparities in Disability Approximately 1 out of 3 Black and Hispanic.
Care Transitions (CT) Special Innovation Project (SIP) THIS MATERIAL WAS PREPARED BY THE ARKANSAS FOUNDATION FOR MEDICAL CARE INC. (AFMC), THE MEDICARE.
The Business Case for Bidirectional Integrated Care: Mental Health and Substance Use Services in Primary Care Settings and Primary Care Services in Specialty.
West Coast University NURS 204
©2010 McGraw-Hill Higher Education. All rights reserved. Chapter 10 Disorders Co-occurring with Substance Abuse.
Reduction Of Hospital Readmissions Hany Salama, MD Diplomat ABIM IM Hospice and Palliative Care Sleep Medicine.
Medicaid and Behavioral Health – New Directions John O’Brien Senior Policy Advisor Disabled and Elderly Health Programs Group Center for Medicaid and CHIP.
Health and Transportation – Partners in Wellness & Affordable Healthcare Mary Leary, Vice President, Easter Seals Transportation.
Learn more about ways to Bend the Curve in health care costs at: Made possible through support from: Preventing Hospital Readmissions:
Unintended Consequences of Measures to Reduce Readmissions and Reform Payment—Threats to Vulnerable Older Adults by Mary D. Naylor, Ellen T. Kurtzman,
DataBrief: Did you know… DataBrief Series ● September 2010 ● No. 3 Dual Eligibles and Medicare Spending For patients with 5 or more chronic conditions,
Gaps in Drug Benefits: Impact on Utilization and Spending for Drugs Used by Medicare Beneficiaries with Serious Mental Illness Linda Simoni-Wastila, PhD.
DataBrief: Did you know… DataBrief Series ● February 2013 ● No. 36 Medicare Beneficiaries With Severe Mental Illness and Hospitalization Rates In 2010,
Alliance Hill Briefing May 4, 2012 Healthcare Integration: The Behavioral Health Perspective.
Finding Supportive Housing in Health Homes Mohini Venkatesh National Council for Community Behavioral Healthcare.
DataBrief: Did you know… DataBrief Series ● May 2012 ● No. 29 Prevalence of Alzheimer’s Disease and Other Dementias In 2009, 13% of dual-eligible beneficiaries.
Integrating Mental Health, Physical Health and Substance Use for low income Medi- Cal and Uninsured Populations in California ITUP Conference – Panel Discussion.
Specific Aim 1: Determine the impact of psychiatric disorders on the hospital length of stay (LOS) in pediatric patients diagnosed with SCD admitted for.
Health Care Reform Primary Care and Behavioral Health Integration John O’Brien Senior Advisor on Health Financing SAMHSA.
DataBrief: Did you know… DataBrief Series ● October 2011 ● No. 24 Medicare’s Highest Spenders In 2006, Medicare spent almost 90 times more per capita on.
DataBrief: Did you know… DataBrief Series ● October 2011 ● No. 20 Seniors with Chronic Conditions and Functional Impairment In 2006, over 26% of seniors.
DataBrief: Did you know… DataBrief Series ● September 2010 ● No. 1 Characteristics of Dual Eligibles 33% of dual eligibles suffer from diabetes, stroke,
DataBrief: Did you know… DataBrief Series ● February 2011 ● No. 11 Eligibility Pathways for Dual Eligibles In FY 2008, over 9 million Medicare beneficiaries.
Behavioral Health: Can Primary Care Help Meet the Growing Need? Deanna Okrent Alliance for Health Reform May 4, 2012.
Maggie Labarta, PhD President/CEO April 27, 2011.
© 2005 Neighborhood Health Plan of Rhode Island. All rights reserved. Reproduction or redistribution in any form without the prior written permission of.
DataBrief: Did you know… DataBrief Series ● February 2013 ● No. 38 Medicare Spending for Beneficiaries with Severe Mental Illness and Substance Use Disorder.
THE URBAN INSTITUTE Examining Long-Term Care Episodes and Care History for Medicare Beneficiaries: A Longitudinal Analysis of Elderly Individuals with.
Health Care Costs: The Role of Technology and Chronic Conditions Bruce Chernof, MD President & CEO Alliance for Health Reform:
DataBrief: Did you know… DataBrief Series ● February 2013 ● No. 35 Prevalence of Chronic Conditions Among Seniors with Severe Mental Illness In 2010, 53%
DataBrief: Did you know… DataBrief Series ● October 2011 ● No. 21 Dual Eligibles, Chronic Conditions, and Functional Impairment In 2006, 37% of seniors.
Non-Preventable Readmissions Are Assigned to One of 7 Categories: 1.Not Clinically Related 2.Clinically Related, but not preventable 3.Planned 4.Trauma.
DataBrief: Did you know… DataBrief Series ● September 2010 ● No. 2 Dual Eligibles and Chronic Conditions 28% of Medicare beneficiaries with 5 or more chronic.
DataBrief: Did you know… DataBrief Series ● September 2010 ● No. 4 Low-Income Seniors Seniors living alone have 35% less annual income than seniors living.
Long-Term Care: Exploring the Possibilities Improving Medical and Social Service Coordination for Persons with Chronic Illness Mark R Meines, Ph.D. George.
“SEVERE MENTAL ILLNESS & CONGESTIVE HEART FAILURE OUTCOMES AMONG VETERANS” by Jim Banta UCLA Committee members: Alexander Young, Gerald Kominksi, William.
DataBrief: Did you know… DataBrief Series ● September 2011 ● No.19 Differences in Hospitalization Rates By Residence Community residents are nearly twice.
The Benefits of Homecare Occupational Therapy Services for Individuals With Stroke The money we put in now will create a ripple effect that will lead to.
1. The Healthcare Economy in Transition/ An Overview of the Emerging ACO Imperative Erik Johnson Senior Vice President, Avalere Health 2.
DataBrief: Did you know… DataBrief Series ● September 2011 ● No.18 Differences in Service Utilization by Disability and Residence In 2006, seniors with.
PONCE HEALTH SCIENCES UNIVERSITY PONCE RESEARCH INSTITUTE Puerto Rico Improve Medication Adherence & Effective Use Of E-prescribing.
Health Reform: Understanding and Navigating the
Dual Eligibles and Medicare Spending
Health Reform: Understanding and Navigating the
Information for Network Providers
Heart Failure Management Coordinated Care Approaches
Medicaid Matters: Depression and other Psychiatric Illnesses
Non-Preventable Readmissions Are Assigned to One of 7 Categories:
Presentation transcript:

DataBrief: Did you know… DataBrief Series ● February 2013 ● No. 37 Medicare Beneficiaries With Severe Mental Illness and Re- Hospitalization Rates In 2010, Medicare beneficiaries age 65 and older with severe mental illness (SMI) were nearly 1.7 times more likely to be readmitted after a hospital stay than those without SMI?

Severe mental illnesses (SMI) “disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning” and can significantly decrease life expectancy. 1,2 For the purpose of this analysis, SMI is defined as major depression, other mood disorders, and psychoses. 46% of Medicare beneficiaries age 65 and over with SMI were hospitalized in 2010, compared to only 17% of Medicare beneficiaries without SMI. The rate of 30-day rehospitalizations is considered an indicator of quality of care, as a rehospitalization within a short timeframe may indicate poor medication management or poor clinical follow up with the beneficiary after the first hospitalization. Among Medicare beneficiaries age 65 and older who were hospitalized in 2010, SMI was associated with a greater rate of rehospitalizations within 30 days of the initial hospital admission. 3 22% of Medicare beneficiaries age 65 and older with SMI were rehospitalized within 30 days, compared to 13% of those without SMI. Substance use disorders (SUD), which often co-occur with SMI, increased the incidence of 30-day rehospitalizations; 34% of seniors with both SMI and SUD were rehospitalized. Seniors who are dually eligible for Medicare and Medicaid, or dual eligibles, with SMI had higher rates of rehospitalizaition within 30 days than Medicare-only beneficiaries with SMI. Medicare Beneficiaries With Severe Mental Illness and Hospitalization Rates Page 2 DataBrief (2013) ● No National Alliance on Mental Illness. “What is Mental Illness: Mental Illness Facts.” 2 Colton, Craig and Ronald Manderschied. “Congruencies in Increased Mortality Rates, Years of Potential Life Lost, and Causes of Death Among Public Mental Health Clients in Eight States.” Preventing Chronic Disease 3(2) (2006). 3 Avalere Health, LLC analysis of 2010 Medicare Standard Analytic Files.

Medicare Beneficiaries Age 65+ With Severe Mental Illness Are More Likely to be Rehospitalized After a Hospital Stay Than Beneficiaries Without Severe Mental Illness DataBrief (2013) ● No. 37 Page 3 1 This analysis includes admissions and readmissions to short-term acute care hospitals (STACHs) only; it excludes psychiatric and rehabilitation hospitals. 2 N = 569,620 dual eligibles without SMI with a STACH stay, 165,960 with SMI with a STACH stay, and 3,580 with SMI and substance use disorder (SUD) with a STACH stay. 3 N = 3,103,040 Medicare-only beneficiaries without SMI with a STACH stay, 394,740 with SMI with a STACH stay, and 4,660 with SMI and SUD with a STACH stay.

About the data: Analytics powered by Avalere Health LLC A Clear Policy Connection In 2010, Medicare beneficiaries age 65 and older with SMI, and especially those with co-occurring SUD, had higher rates of both hospitalization and re-hospitalization within 30 days than senior beneficiaries without. This finding suggests that the presence of SMI complicates treatment plans and post-discharge care. These same Medicare beneficiaries with SMI also had high rates of other chronic conditions. SMI and SUD can make it difficult for patients to maintain medication and other treatment regimens, which may contribute to adverse events like rehospitalizations. 1 Policymakers and providers are increasingly focused on reducing hospital readmissions by providing enhanced services to patients during care transitions. The Affordable Care Act included a provision, implemented in October 2012, that now penalizes hospitals that have higher than expected rehospitalization rates. Given the higher prevalence of readmissions among those beneficiaries with SMI and SUD, the implementation of this provision encourages hospitals to better coordinate with community-based providers, including behavioral health providers, to ensure beneficiaries do not get readmitted. This analysis used 2010 Medicare claims data to identify individuals with severe mental illnesses. Individuals were defined as having severe mental illness if their Medicare claims had one or more International Classification of Diseases, Version 9 (ICD-9) codes associated with selected severe mental illnesses in any acute care setting. Severe mental illnesses included depression, bipolar disorder, schizophrenia, and other psychotic disorders. This analysis is limited to individuals age 65 and older enrolled in the fee- for service, or traditional, Medicare program, and excludes beneficiaries who died in DataBrief (2013) ● No. 37 Page 4 1 Druss, Benjamin and Elizabeth Reisinger Walker. “Mental Disorders and Medical Comorbidity.” Robert Wood Johnson Foundation, research/2011/02/mental-disorders-and-medical-comorbidity.htmlhttp:// research/2011/02/mental-disorders-and-medical-comorbidity.html