Dissemination of a Behavioral Health Home Model with Improved Physical Health and Wellness across Behavioral Health Settings

Autor: Shari L. Hutchison, James M. Schuster, Amy D. Herschell, Irina Karpov
Rok vydání: 2021
Předmět:
Zdroj: Health Serv Res
ISSN: 1475-6773
0017-9124
DOI: 10.1111/1475-6773.13770
Popis: RESEARCH OBJECTIVE: Behavioral Health Home Plus (BHHP) is an evidence‐based model to enhance physical health and wellness for individuals with serious mental illness (SMI) and chronic medical conditions. To better understand model effectiveness and best practices for dissemination, we implemented BHHP in 7 adult Opioid Treatment Programs (OTP) and 5 youth Residential Treatment Facilities (RTF). STUDY DESIGN: We utilized a hybrid study design to examine dissemination and support of BHHP through a 12‐month Learning Collaborative (LC) and outcomes via propensity‐score matched analyses. Mixed methods included semi‐structured staff interviews and confidence surveys to assess feasibility. Data were collected on involvement/confidence in managing physical health (survey) and utilization of primary/specialty care and unplanned healthcare (claims) over 18‐months. POPULATION STUDIED: In Pennsylvania's Medicaid HealthChoices program, behavioral health agencies serve as health homes with support and training in wellness by a behavioral health managed care organization, Community Care Behavioral Health of the UPMC Insurance Services Division. Enrollment into BHHP for OTP included adults (n = 689), average age 39.19 ± 9.99 years, 60% female and youth (n = 354) for RTF, average age 14.04 ± 2.52 years, 31% female. Propensity score matching was successful for OTP (n = 688) and RTF (n = 312) members. PRINCIPAL FINDINGS: Providers reported barriers (training time, staff turnover, workflow integration, family engagement) and facilitators (model resources, education on population‐specific health topics, learning from other sites implementation experiences) to implementation. At 18‐month follow up, over 70% of staff reported being highly confident in working with individuals on physical health and wellness; over 60% of service‐users reported being highly involved in working with their behavioral health provider on physical health and wellness, and 67% of OTP and 43% of RTF service‐users reported being highly confident in their ability to manage their physical health and wellness. Service utilization outcomes showed large decreases over 18 months in medically emergent care for OTP members while rates remained steady for the matched comparison group (p = 0.0055); a similar pattern was found for medications for physical health chronic conditions (p
Databáze: OpenAIRE
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