APA Unveils Report on Cost-Effectiveness of Integrated Care

“The key to the sauce of health care reform is mental health, and the key ingredient in that sauce is integrated care,” said APA President Jeffrey Lieberman, M.D. (at right in photo), opening a press briefing and roundtable discussion sponsored by APA this morning in Washington, D.C., on “Integrated Primary and Mental Health Care: Reconnecting the Brain and the Body.”

The event marked the release of a new report, “The Economic Impact of Integration: Implications for Psychiatry,” by the international actuarial firm Milliman Inc. That report found that general medical costs for patients who have behavioral health disorders are 2-3 times higher than for those without behavioral illness. In fact, the additional health care costs incurred by people with behavioral comorbidities were estimated to be $293 billion in 2012. Effective integration of medical and behavioral care could save $26 billion to $48 billion annually in general health care costs, according to the report. The report considers commercial, Medicare, and Medicaid patient populations and includes utilization and cost data from millions of patients. Moreover, it compares data from those with both chronic medical conditions and behavioral conditions with data from those with only chronic medical conditions.

“Mental illness is important not only because of the pain and suffering it causes, but because it is too large to ignore,” said APA President-elect Paul Summergrad, M.D. (at left in photo) at the press conference.

The event brought together leaders in the movement toward integrated and collaborative care who emphasized that a key to addressing rising costs in American health care is integrated care that addresses the mental health needs of patients in primary care, as well as the primary care needs of those in specialty mental health settings. Speakers included Michael Hogan, Ph.D., former commissioner of the New York State Office of Mental Health; John O’Brien, senior policy advisor at the Centers for Medicare and Medicaid Services; Michael Shoenbaum, Ph.D., senior advisor for mental health services, epidemiology, and economics at NIMH; Elinore McCance-Katz, M.D., chief medical officer at SAMHSA; Henry Chung, M.D., medical director for the Montefiore Accountable Care Organization; Frank deGruy, M.D., professor and chair of the Department of Family Medicine at the University of Colorado School of Medicine; and Keris Myrick, Ph.D., M.B.A., president of the National Alliance on Mental Illness.

“Together we believe we can reunite the brain and the body,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A. “Now is the time to do it.”

(Image: David Hathcox)

Issues Cited by President Kennedy in 1963 Said to Still Affect Mental Health Policy

President John F. Kennedy’s 1963 Community Mental Health Act was signed 50 years ago, but it resonates with contemporary federal policy on mental health. Kennedy’s messages to Congress included references to financing mental health care in the same way as other medical services, the need to overcome mental health care disparities, a nod towards what would be called “recovery” today, and references to social determinants of health, said Substance Abuse and Mental Health Services Administrator Pamela Hyde, J.D., at the Kennedy Forum Inaugural Conference in Boston yesterday.

Thursday’s conference coincided with other current policy developments in the care of people with mental illness, added APA President Jeffrey Lieberman, M.D. “We have the Affordable Care Act being rolled out, the final rule on the mental health parity act being issued soon, and the symbolic inspirational power of the 1963 act, which was the first legislation to truly envision how mental health care could be provided in a much more humane and much more effective way in our society,” said Lieberman. (Lieberman is shown in the photo above with former U.S. Surgeon General David Satcher, M.D., at yesterday's forum.)

The Kennedy Forum's event on the 50th anniversary of the Community Mental Health Act was a major step, but not the last, said former member of Congress Patrick Kennedy, the late president's nephew, who convened the conference and who has spent his post-congressional career leading efforts to improve mental health and substance use research and services. To follow up, scientific, advocacy, and professional organizations are likely to unite to refine and clarify future directions for the public and Congress. “We need to determine what the policy priorities are, so we spend our time working on the things that have the greatest leverage to improve the whole world of mental health,” Kennedy stated.

To read more in about the work of Patrick Kennedy, see the Psychiatric News article "Kennedy Makes Suicide Concerns Focus of National Media Tour."

 (Photo: Aaron Levin, Psychiatric News)