New white paper addresses behavioral healthcare in the ED and the SDoMH
The social determinants of health (SDoH) are on everyone’s watch list, but attention must also go to the social determinants of mental health (SDoMH). The costs incurred to treat behavioral health and substance abuse in emergency departments are rapidly escalating. Poor management of these patients drains already tapped resources and provides limited meaningful treatment.
A recently released white paper by the Institute for Healthcare Improvement and Well Being Trust organizations hopes to shift the care dilemma. The paper, Improving Behavioral Healthcare in the Emergency Department and Upstream, provides hospital EDs and their community partners with strategic guidance to render more compassionate, seamless, and effective systems of care for patients with mental health conditions. The guidelines are important considerations to mitigate gaps in care, enhance treatment processes, and reduce costs and readmissions.
The SDoMH invokes major challenges for EDs. They drive unnecessary visits; the average patient with psychiatric needs directly costs an ED $1,198-$2,264 per visit. These patients can easily present dozens of times annually, and for varied reasons: inability to access appropriate and timely psych follow-up, and access of prescriptions, to name a few. To make matters worse, mental health and substance abuse treatment deserts exist throughout the country, especially in rural regions. This fact leaves EDs as often the only site to access care. Assorted reports identify how Medicaid recipients face greater challenges in obtaining needed behavioral health and substance abuse treatment. Creative ways to incorporate behavioral health models in EDs, as well as in primary care, is a clear mandate. These types of proactive solutions to the SDoH and SDoMH minimize the currently rampant reactive responses.
Eight U.S. hospitals engaged in agreeing to become part of an 18-month learning community. The hospitals included:
Participants tested strategies for improving patient outcomes and experiences of care. They were able to profoundly decrease avoidable repeat ED visits for individuals with mental health and substance use disorders. Additionally, several of the hospitals reduced:
This triple-headed monster impacts workforce safety, retention, and burnout across every setting, further impacting the fiscal and human toll incurred by the SDoMH.
The white paper provides a number of recommendations, including:
The recommendations should be implemented across healthcare organizations. It is expected that they will contribute to much-needed efforts that effect change toward providing holistic healthcare to ED consumers.
Programming Note:
Listen to Ellen Fink-Samnick’s live reporting on the State of the Union of SDoH on Monitor Mondays, 10-10:30 a.m. EST.
May is National Mental Health Awareness month, and slightly more than half of American adults are estimated to be suffering from some form of mental
Last week, the chief medical officer (CMO) for the Centers for Medicare & Medicaid Services (CMS), Dora Hughes, MD, MPH, published a blog in Health
Please log in to your account to comment on this article.
Dr. Ronald Hirsch provides tried-and-true strategies and insight into outpatient in hospital bed stays including determining the applicable definition, who uses it, and when and how to bill for this circumstance, solidified with concrete case examples and expert insight.
Practical solutions for CDM departments to protect your hospital’s revenue.
This webcast teaches hospitals how to comply with CMS price transparency rules and compare their rates with peer hospitals. It covers creating a compliant machine-readable file, comparing negotiated rates, and improving pricing decisions.
The No Surprises Act (NSA) presents a challenge for hospitals and providers who must provide Good Faith Estimates (GFEs) for all schedulable services for self-pay and uninsured patients. Compliance is necessary, but few hospitals have been able to fully comply with the requirements despite being a year into the NSA. This webcast provides an overview of the NSA/GFE policy, its impact, and a step-by-step process to adhere to the requirements and avoid non-compliance penalties.
This expert-guided webcast will showcase tips for providers to ensure appropriate capture of the work performed for a visit. Comprehensive examples will be given that demonstrate documentation gaps and how to educate providers on the documentation necessary to appropriately assign a level of service. You will gain clarification on answers regarding emergency department and urgent care coding circumstances as well as a review of how/when it is appropriate to code for E&M in radiology and more.
Set yourself up for financial and compliance success with expert guidance that breaks down the impactful changes including MS-DRG methodology, surgical hierarchy updates, and many new technology add-on payments (NTAPs). Identify areas of potential challenge ahead of time and master solutions for all 2024 Proposed IPPS changes.
Do you struggle with selecting and appending the correct modifier for your medical claims? Join our must-attend webinar, “Mastering Modifier Usage: Preventing Denials and Ensuring Compliance” to reduce claim denials and improve your reimbursement rates.
Kay Piper reviews the guidance and updates coders and CDISs on important information in the AHA’s fourth quarter 2023 ICD-10-CM/PCS Quarterly Coding Clinic in an easy to access on-demand webcast.
Copyright © 2023 ICD10monitor. Powered by MedLearn Media.
