Community-based ACOs: Powerful models to improve behavioral health

A Housing First patient in Camden, NJ in her new home.

A Housing First patient in Camden, NJ in her new home.

A recent report published by Rutgers identified that about 86 percent of the top 1 percent highest-spending Medicaid patients in our state suffer from a behavioral health diagnosis. Given these statistics, New Jersey’s three certified community-based ACOs recognize that addressing behavioral health issues in their local communities is a key component of their success. The Camden, Trenton, and Newark ACOs serve individuals who present with mental health and substance abuse issues at a significantly high rate—approximately 1 in 4 ACO patients has a behavioral health diagnosis.

Bringing community-based, coordinated care to complex patients in New Jersey, the three ACOs are advancing behavioral health initiatives in their communities.

  • The Housing First program for medical super users in Camden supports many individuals with mental health and substance abuse issues. Preliminary results of this program show a 40 percent reduction in hospital utilization.

  • Citywide quality improvement initiatives to increase access, capacity, and treatment options for patients suffering from mental health and substance abuse. Focusing on improving local access and provider capacity to write prescriptions for suboxone, a medication assisted treatment for opioid use.

  • Sharing protocols for patients with substance use issues in the ED. The Trenton ACO is working to develop shared protocols and procedures among their three area hospitals for patients presenting with substance abuse issues in the ED.

  • ACO data and technology infrastructure as well as its unique ability to convene multiple and competing stakeholders has allowed the Camden Coalition to serve a key role in the South Jersey Behavioral Health Innovation Collaborative (SJBHIC), which aims to improve the coordination and delivery of behavioral health care in the five participating south jersey hospitals.

The ACOs, their communities and patients have all deeply invested in the Demonstration Project and are committed to improving quality, outcomes and efficiencies in a highly complex and entangled Medicaid system. In the areas of behavioral health, we are beginning to see their promise. The three ACOs were able to use state funding to build and sustain important data and information infrastructure to support population health initiatives, support stakeholder engagement to allow for improved community-wide coordination and collaboration, and build capacity for city-wide and targeted quality improvement work. The ACOs need continued state funding to see the Demonstration Project through to completion and continue to build upon the good work, the data and quality improvements each has begun to see in their communities, especially in the area of behavioral health.

Published on April 24th, 2017