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Health & Medicine at CBHA

Sharon Post
January 8, 2016
In December I attended my first Community Behavioral Healthcare Association (CBHA) conference. I saw a few old allies, a handful of new partners from our Learning Collaborative, and made some new contacts. As the Center for Long-Term Care Reform continues to wade into the choppy waters of behavioral health policy, I wanted to share a few of my reflections from the 2015 CBHA conference:

1. Make data meaningful. Data is how we communicate, and how we communicate matters.
  • Laura Galbreath from the National Council reminded us that data analytics are the key to identifying community needs, measuring the success—in terms of both quality outcomes and total costs—of preventive interventions, and thereby fulfilling the promise of population health approaches.
  • Tia Goss Sawhney of Milliman pointed out that access to care isn’t assured by federal rules alone, and we need to advocate for reimbursement in the context of access requirements. We get what we pay for, and we need to pay more attention to what we pay for, how we pay for it, and whom we pay to do it so that we can find ways to improve incentives and align reimbursement with our goals of quality, access, and integration.
  • Joseph West from NextLevel Health reminded us that the current state of data analytics is pretty lousy. State data and data systems are woefully inadequate to support care coordination. Insurers’ data dashboards collect claims data but have not yet mastered connecting those data to real time demographic data that help us understand the populations we serve. Without this information, we can’t identify what’s driving poor outcomes and costs, develop a strategy that makes sense for that community, or show the value of those interventions.
  • We have to understand populations to manage their health, but as John Lyons from Chapin Hall reminded us, you manage what you measure. So if agencies are measuring state licensing requirements, that’s what they will manage. And if the only data providers give to the State is about billing, then State agencies will manage bills (i.e. make cuts). State agencies in particular need to collect and use data in a way that tracks clinical and functional outcomes and measures the value of the programs they pay for, rather than for auditing and licensure compliance checks.
  • We heard about innovative programs that are getting results in the Quad Cities, Dixon, Lawndale in Chicago, and Franklin County. If something does work, payers, providers and advocates need to do a better job identifying the foundations of success, who is going to invest in it, and who is going to actually do it.
2. Promise of breathtaking transformation in the state behavioral health system. Despite the current budget impasse and the damage it has done to Illinois’ behavioral health infrastructure, the state agency directors on the State Direction panel spoke hopefully about the unprecedented level of collaboration among their departments and the system reform that is coming in 2017. We’ll be keeping our eye out for news of those big changes in the new year.

3. You’re gonna die… It’s jarring to hear that but we say it all the time when we cite research that shows a shocking disparity in mortality for people with serious mental illness. Instead of saying, “If you have mental illness, you’re going to die 25 years earlier than other people,” we need to  shift the focus to the system failures that actually underlie this statistic, and what we can do to reverse it. For a start, I think it could be as simple as saying, “People with mental illness lose, on average, 25 years of life due to our failure to provide quality, integrated health care,” and then talk about what we can do about it.

4. Marvin Lindsey! This was my first every CBHA conference and it was Marvin’s first as CEO. Marvin has been a great supporter of Health & Medicine’s Learning Collaborative from the very beginning (when it was just an idea I shared with him at a West Loop coffee shop). One of the qualities that define Marvin for me is his insuppressible joy in the face of enormous challenges, a joy that does not take away from the seriousness with which he approaches the mission of community behavioral health agencies and strengthens the resolve of everyone around him.