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Ohio’s mental health clients will have better access to the integrated, coordinated care of Health Home services

IN BRIEF: A person-centered system of care, called a health home, is the approach of choice for providing well-coordinated care to Ohioans with serious and persistent mental illness. It's a system based on shared information, seamless communication, and meaningful referrals between the physical and behavioral health systems. Of course, this single-system approach isn't unfolding automatically -- it has been developed thanks to focused effort among people throughout state government and elsewhere. As a part of this work, a Kaizen team created a streamlined process for Health Home Certification and information exchange, and for the management of Health Home providers and client enrollment.

STREAMLINED PROCESS: The Health Home Roadmap process, in which a Community Behavioral Health Center applies to be a provider, will take 13-36 days with the new approach -- compared to 120-213 days before.

STRAIGHTFORWARD APPLICATION: The certification application has been significantly simplified. The new version will have 10 pages, compared to 21 pages and a 3-page pre-application with the previous process.

COST SAVINGS: According to team calculations, the cost to process Business Associate Agreements will be cut in half.

This team, like all teams in a Kaizen event, spent hours engaging in dialogue – analyzing their process, discussing ideas for improvement, building consensus, and developing action plans. These team-oriented exchanges are a key ingredient in every Kaizen success story.

Ohioans with serious and persistent mental illness have traditionally received services through separate systems: physical health benefits through Medicaid and behavioral health benefits through the Ohio Department of Mental Health and Addiction Services.

The separateness of these systems can complicate coordination among providers or services at the local level. As a result, people often are served in "silos" without the benefit of shared information among providers or meaningful referrals between the physical and behavioral health systems.

Governor Kasich's first Jobs Budget authorized Ohio Medicaid to design a person-centered system of care, called a health home, to improve care coordination for high-risk beneficiaries. The idea is to have one system that replaces silos with shared information and seamless coordination among providers -- along with meaningful referrals between the physical and behavioral health systems.

The overarching aim is to improve the experience of care, quality of life, consumer satisfaction, and improve health outcomes. Additional improvements include lower rates of hospital emergency department use, reduced hospital admissions and re-admissions, reduced healthcare costs, and decrease reliance on long-term care facilities.

How's this for efficiency? The improved process will have 148 fewer steps. That's a 77% reduction over the previous approach.

There are many processes that are involved in this vision of a single seamless system. One of the biggest served as the focus of a Kaizen event aimed at creating an efficient process for Health Home Certification and information exchange.

A 15-person Kaizen team set out to develop a streamlined and sustainable information exchange process that begins when a patient-centered Community Behavioral Health Center submits a pre-application/notification of intent to apply -- and ends when health home processes are discontinued for dis-enrolled clients.

The team evaluated every step of the current process, identified and analyzed key roadblocks, brainstormed potential improvements, achieved consensus on a way forward, and developed a future-state process along with a set of detailed implementation plans.

The new process involves 77% fewer steps and 89% fewer decision point. All 54 points of waste and inefficiency in the old process are gone for good in the new way of doing things.

Before, the process had been taking 120-213 days. It is estimated that when all of the improvements are implemented, the new process will take just 13-36 days -- while cutting in half the processing costs of the Business Associate Agreement.

Driving these dramatically improved numbers is a transformed Health Home Certification Application. The team eliminated a 3-page pre-application and cut the formal application from 21 pages to 10 pages. The new app eliminates redundancies while increasing alignment with evaluation criteria.

In addition, the team simplified the overall Health Home Certification Process. In addition to a streamlined flow with a more efficient review and fewer requests for additional information, there will be a single point of contact for providers.

Also, team members streamlined Health Home Client Enrollment, developing functionality for providers to pull client information as needed to support client identification and online enrollment.

It all adds up to greater coordination, better communications, increased sharing of information -- and improved service to Ohioans who will truly benefit.

Download a 1-page fact sheet
Download a 2-page article
Download the team report-out
All downloads are in PDF format

This report was published August 23, 2013. Projected and actual results may have changed since then. For the latest info, contact the Ohio Department of Mental Health & Addiction Services or LeanOhio.

    OhioMHAS contact:
    Jody Lynch

Ohio Department of Mental Health & Addiction Services, Ohio Department of Job and Family Services
Health Home Certification Process
May 2013

Team members
Team members: Jody Lynch (Team Leader), Afet Kilinc, Matthew Loncaric, Cheryl Reed, Alan Rogers, Rob Husted, Gina McDonald, Sivakumar Raju, Mary Haller, Peggy Smith, Teresa Lampl, Janel Pequignot, Lynne Lyon, Kathy Yokum, Elisha Ehnes