A penny saved is a penny earned: Pharmacy and behavioral health cost savings in pediatric IPC clinics Paul Kettlewell, Ph.D. Tawnya J. Meadows, Ph.D. Shelley J. Hosterman, Ph.D. Vanessa Pressimone, Ph.D. Collaborative Family Healthcare Association 16 th Annual Conference October 16-18, 2014 Washington, DC U.S.A. Session F 1 c Friday October 17, 2014
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Paul Kettlewell, Ph.D. Tawnya J. Meadows , Ph.D. Shelley J. Hosterman , Ph.D.
Session F 1 c Friday October 17, 2014. A penny saved is a penny earned : Pharmacy and behavioral health cost savings in pediatric IPC clinics. Paul Kettlewell, Ph.D. Tawnya J. Meadows , Ph.D. Shelley J. Hosterman , Ph.D. Vanessa Pressimone, Ph.D. - PowerPoint PPT Presentation
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A penny saved is a penny earned: Pharmacy and behavioral health cost
savings in pediatric IPC clinicsPaul Kettlewell, Ph.D.
Tawnya J. Meadows, Ph.D.Shelley J. Hosterman, Ph.D.Vanessa Pressimone, Ph.D.
Collaborative Family Healthcare Association 16th Annual ConferenceOctober 16-18, 2014 Washington, DC U.S.A.
Session F 1 cFriday October 17, 2014
Faculty Disclosure
• We have not had any relevant financial relationships during the past 12 months.
Learning Objectives
At the conclusion of this session, the participant will be able to:
• Identify data collection procedures to measure outcomes on cost offset.
• Describe pharmacy savings found.
• List two plausible reasons why behavioral health costs were found to be relatively cheaper per member per month in integrated primary care clinics versus standard primary care clinics.
Bibliography / Reference
Cummings, N.A., O'Donohue, W.T., & Cummings, J.L. (2009). The financial dimension of integrated behavioral/primary care. Journal of Clinical Psychology in Medical Settings, 16, 31-39. doi:10.1007/s10880-008-9139-2 Felleman, B.I., Athenour, D.R., Ta, M.T., & Stewart, D.G. (2013). Behavioral health services influence medical treatment utilization among primary care patients with comorbid sustance use and depression. Journal of Clinical Psychology in Medical Settings, 20, 415-426. doi:10.1007/s10880-013-9367-y Monson, S.P., Sheldon, J.C., Ivey, L.C., Kinman, C.R., & Beacham, A.O. (2012). Working toward financial sustainability of integrated behavioral health services in a public health care system. Families, Systems, & Health, 30, 181-186. doi:10.1037/a0028177 Wiley-Exley, E., Domino, M.E., Maxwell, J., & Levkoff, S.E. (2009). Cost-effectiveness of integrated care for elderly depressed patients in the PRISM-E study. Journal of Mental Health Policy & Economics, 12, 205-213.
Thielke, S. (2011). Health psychology in primary care: recent research and future directions. Psychology Research and Behavior Management, 4, 59-68. doi:10.2147/PRBM.S12996
Learning Assessment
• A learning assessment is required for CE credit.
• A question and answer period will be conducted at the end of this presentation.
Pediatric IPCModel & Outcomes
Clinical Model & Services
Three pilot sites• Psychologist (4 days/week)• Postdoc fellows (2-3 days/week)
Behavioral health schedules• 6-7 billable units a day• Family, individual, group• Gaps in schedule for integrated activities• Always available
Clinical Model & Services
• Sites & staff• Problem focused
eval/treatment• Family, individual, &
group therapy• Consults & hand-offs• Crisis appointments• Same day evaluations
n = 85 (91.4%)Data represents a savings of $560K just in hospitalization costs
n = 2 (2.1%)
GHP Data: Bending the Cost Curve
IPC Book
Average Total Behavioral Health Spend 12.0% 22%
UBH Claims5% 18.3%
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• Average length of treatment in IPC (3.7 sessions) as compared to usual care (18.9 sessions). Able to serve more patients
Reduction in PMPM for Medications
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Allo
wed
PM
PM
Time of IPC Implementation
GHP Data: Bending the Cost Curve
IPC Book
Average Total Pharmacy Spend 9.8% 35.5%
BH medication35.6% 55.8%
Non BH medication -19.5% 15.8%
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Reduced Costs: Treatment Costs
• Total revenue generated per session resulted in significant gains for IPC clinic vs. control clinic (*p< .01)
• Possible factors: Less staffing, higher show rates, lower drop out rates, shorter courses of treatment
DBD Anxiety Depression
■ Control■ IPC
Reduced Costs: Medication Utilization
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• Prescription medications/month decreased by 3.25% after integration. Stimulant prescriptions decreased marginally. Levels & trends did not change among the control sites.
Implications
• Value-based payment
Or• Share in cost savings
Or• Payment based upon members
Or• Flat percentage more of payment due to value added
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Session Evaluation
Please complete and return theevaluation form to the classroom