Case Management

Mentor moment: Addressing mental health issues improves patients' physical health

Case Management Weekly, February 3, 2010

The following article is adapted from HCPro’s resource for hospital case managers—www.CaseManagementMentor.com—a free blog dedicated to connecting hospital case managers to industry pacesetters, peers, and best practices.

Only five percent of the patient population is complex, yet they account for more than half of healthcare costs, according to Cartesian Solutions, Inc.™. Of that five percent, two-thirds have concurrent mental and physical health issues.

Poor communication between physicians who treat physical issues and providers who treat mental problems can cause complex patients to consume more resources. The lack of communication is due to the reimbursement model; it pays for physical treatments and mental treatments separately

Before the advent of managed care, physicians managed a patient’s physical and mental health problems. Some physicians owned treatment centers for the treatment of alcoholism, eating disorders, and other behavioral health issues, says Rebecca Perez, RN, CCM, CPUM, president and owner of Carative Health Solutions. However, payers realized that those resources were abused and have separated physical and mental health reimbursement, thereby limiting access to mental health treatment.

Limited access has caused a segment of the patient population to remain untreated, potentially causing them to seek more physical health treatment, thereby consuming more resources.

Perez is part of a growing movement addressing that issue by striving for a more integrated care management model that assesses patients’ physical and mental health issues simultaneously.

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