undertaken by the office of mental health and mental retardation in partnership with allegheny...
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Undertaken by the Office of Mental Health and Mental Retardation
In partnership with Allegheny HealthChoices, Inc.October 1, 2009
Washington CountySystem Review
Project Advisory Committee
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Agenda
Introductions Review of Meeting Notes Project Update Washington County Data Discussion Wrap up / Next Meeting
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Project Update
Letter to stakeholders
Meetings with County staff
Provider forum
Data collection and analysis
Interviews
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Project Update cont’d.
Interviews
Who– Providers– County committees and departments– Consumer and family support groups, advocates– Interface agencies
How– One-on-one interviews – Group interviews – Focus groups – Attending existing meetings
What– Focus on exploring key areas of project4
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Project Update cont’d.
Data Collection and Analysis
Review available data– Information Systems survey
Data limitations:– Completeness of the data– Limited cost data for Base-funded services– Limited MR data
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Discussion of County Data:
Purpose
Provide an example of the type of data available
Provide snapshots of Base and HealthChoices Data– Base:
County funded services for people not eligible for HealthChoices Services that are not funded by HealthChoices
– Residential services, administrative case management, social rehabilitation– HealthChoices:
Services available to those who are Medicaid eligible Paid for by the Managed Care Organization/Medicaid
Individuals can receive both Base and HealthChoices services
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BASE HC*1,446 Users 6,344 Users
GENDER Female 48% 53%Male 52% 47%
AGE GROUP
00 – 20 20% 42%21 – 65 + 80% 58%
RACE African-American 7% 10%Caucasian 90% 89%Other ** 3% 1%
Discussion of County Data cont’d.Demographics 2008 Base & HealthChoices (HC)
* *Includes Asian, Native American, Other, and Unknown
* Includes MH services only
A total of 666 users had services in both HC and Base for Washington during 2008 (MH type services only)
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Discussion of County Data cont’d.
Where were people served in 2008?
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Concentrations in: City of Washington and Canonsburg (Washington
Community MH/MR) Mon Valley (SPHS)
Spread throughout southern section of county (Centerville Clinics)
Individuals are also served from other Counties
* HealthChoices Only
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Discussion of County Data cont’d. Users by Service Category: Base & HealthChoices in 2008
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Service Category Base HC
Outpatient MH 558 5,442Case Management/ICM 233 1,217BHRS 0 810Crisis 340 676Inpatient MH 0 657HC Supplemental Serv - MH 0 433Lab 0 306Partial Hosp MH 32 239Family Based Services 2 134CTT 20 38RTF 0 34
Service Category Base HC
Med Check 0 26LTSR / AOP 18 13Psych Rehab 38 1Administrative Management 546 0Community Residential 28 0Emergency Services 17 0Employment Related Services 23 0Facility Based Voc Rehab 10 0Housing Support 148 0RTF - Adult 31 0Social Rehab 146 0
•MH services only• Excludes service categories with less than 10 users
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Discussion of County Data cont’d. Users by Diagnostic Category: Base & HealthChoices in 2008
Diagnostic Category (Age 00-20)
Base(297)
HC(2,710)
ADHD 54 930Adjustment D/O 35 774Neurotic D/O 68 496Major Depression 16 393Psychosis Ch Orig 15 368Conduct D/O 10 323Bipolar D/O 9 311Child-Adol Emot D/O 18 308Depressive D/O 52 270Schizophrenia 1 26
Diagnostic Category (Age 21-65+)
Base(1,153)
HC(3,673)
Major Depression 268 1,396Bipolar D/O 115 905Schizophrenia 189 603Neurotic D/O 174 507Depressive D/O 212 431Adjustment D/O 74 337Unspec Psychosis 11 65Conduct D/O 11 48Org Mental D/O 4 45ADHD 15 38
• Includes the top 10 MH diagnostic categories for both children and adults
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Discussion of County Data cont’d.
HealthChoices Summary: 2008
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Age Group
Users Served
(MH – only)
Paid Amount
(MH – only)% of
Total MHAvg. cost per
user
00 - 20 2,710 $ 13,098,792 64% $4,834
21 - 65+ 3,673 $ 7,301,760 36% $1,988
Total 6,383 $20,400,552
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Discussion of County Data cont’d.HealthChoices 2008: Age 00-20/MH Summary
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Top 3 service categories comprise 70% of total cost for this age groupUsers Avg. cost per user
BHRS 809 $8,349Family Based Services 134 $9,432
Outpatient MH 2,161 $550
Top 3 diagnostic categories comprise 59% of total cost for this age groupUsers Avg. cost per user
Psychosis Ch Orig 368 $10,429
ADHD 930 $2,463
Bipolar D/O 311 $4,932
Top 3 providers comprise 25% of total cost for this age groupUsers Avg. cost per user
Family Behavioral Resources 147 $7,755Southwest Behavioral Care 617 $1,718
Southwood Psychiatric Hospital 119 $8,867
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Discussion of County Data cont’d.HealthChoices 2008: Age 21-65+/MH Summary
Top 3 service categories comprise 78% of total cost for this age groupUsers Avg. cost per user
Inpatient MH 494 $4,623Outpatient MH 3,316 $541
Case Management / ICM 672 $2,426
Top 3 diagnostic categories comprise 75% of total cost for this age groupUsers Avg. cost per user
Schizophrenia 603 $3,787
Major Depression 1,396 $1,374
Bipolar D/O 905 $1,436
Top 4 providers comprise 64% of total cost for this age groupUsers Avg. cost per user
Southwest Behavioral Care 1,002 $2,009Washington Hospital 386 $2,742
Centerville Clinics 429 $1,960Washington Communities MH/MR 723 $1,031
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Discussion of County Data cont’d.Inpatient Utilization:Community IP-MH Admissions
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• Time frame spans the downsizing and closure of Mayview State Hospital• Admissions are trending downward
0
10
20
30
40
50
60
70
Jan-06 Apr-06 Jul-06 Oct-06 Jan-07 Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Oct-09
Admissions Linear (Admissions)
*
* Adult HealthChoices Only
Num
ber o
f Adm
its
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Discussion of County Data cont’d.Inpatient Utilization:Community IP-MH Average LOS
• ALOS is trending very slightly upward, but it has been within one day the entire period.
* Adult HealthChoices Only
Day
s
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Discussion of County Data cont’d.BHRS Utilization: Users and Amount Paid
16• Users and amount paid are trending upward over the
period 28% and 25%, respectively.
Dol
lars
Peop
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Discussion of County Data cont’d.BHRS Utilization: Users and Amount Paid (re-scaled)
• Re-scaled chart with a trend line can provide a different way of viewing the same data
Dol
lars
Peop
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Discussion of County Data cont’d.
What did you think of this data?
What more would you like to see?
Other areas we should consider?
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Wrap up / Next Meeting
Agenda items for the next meeting– Summary of themes from the interviews– Other ideas
Schedule next meeting
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