The Other Half of the Story: ACOs Must Bring Behavioral Health Providers into the Clinical Mix

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Accountable Care Organizations, which used to be the wave of the future, are the here and now. As groups of doctors, hospitals and other healthcare providers come together to coordinate care, it is essential they include behavioral health providers in the mix. According to a recent National Comorbidity Survey, 17 percent of the adult population had comorbid mental and medical conditions within a 12-month period. Patients with comorbidities require a comprehensive treatment plan to truly bend the cost curve.  For example, statistics show a person with diabetes will cost an average of $9,000 per year to treat.  However If that person also has a diagnosis of a behavioral health and/or a substance use disorder, that number skyrockets to more than $36,000 per year. ACOs focused on the whole person will be much better positioned to achieve the needed outcomes and cost reductions required within ACO populations.

Technology should be a facilitator to driving coordinated care and improving outcomes.  ACOs need an effective method to connect and collect client data across all modalities of care, including Behavioral Health.

Those ACOs best positioned will provide their care managers with an easy to use view of the total patient care network.  This view should include clinical data, community support and referral information in a single view.  This will allow the manager, for example, to verify that all needed appointments have taken place for a client and even allow providers to share a care plan so they immediately know what has occurred at the other points of care. A connected ecosystem, providing the entire care network a view into a single care coordination solution, enables this shift to proactive care management.

Netsmart’s CareManagerTM solution, which aggregates clinical and support network data to provide a broad picture of health at the population level, and facilitates care coordination across providers at the individual level, is one example of technology enabling this shift.

Given the prevalence and cost of behavioral health and substance abuse co-morbidities within the general population, it only makes sense that a focus on integrating a behavioral health component into your ACO model would be a wise strategy. Tackling this landscape without a consolidated view, with only half the story, would make supporting accountable care efforts very hard – if not unsustainable.