1. Behavioral Health Solutions for Integrated Health Care & Chronic Disease Management

2. 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
20% of America’s children suffer from obesity
Rapid escalation in the incidence rate for Type II diabetes

3. 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.

4. 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

5. 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

6. 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).

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.

8. 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

9. 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

10. 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

11. 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)

12. 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

13. 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

14. 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

15. Resource Hours

16. Provider Projected Program Cost - current

17. Questions