Health Share Turns its Focus to Mental Health Providers

Health Share of Oregon already has contracts with eight dental care providers, and intends to finalize an agreement with Advantage Dental in 2014 -- but making sure patient demand can be met when coverage kicks in Jan. 1, and finding mental health providers for patients who need them, is going to be the next challenge.   CEO Janet Meyer announced at last week’s community advisory council meeting that earlier in the week, she’d met with CEOs of the other coordinated care organizations, as well as Gov. John Kitzhaber, to talk about enrollment and provider placement. She stressed that placing new enrollees with their preferred providers is a major priority for Health Share, which will get an estimated 40,000 new enrollees Jan. 1. While the Cover Oregon launch -- which is one entry point to coverage for those newly eligible for insurance under the Affordable Care Act -- has been bumpy, an outreach campaign where letters and simple enrollment forms were sent to Supplemental Nutritional Assistance recipients beginning at the end of September has had notably more success.   Meyer also announced a public listening session later this month for new enrollees, which will allow newcomers to ask questions about coordinated care -- and broke the news that Health Share is recruiting for a new, part-time medical officer. Dr. David Labbey, who currently serves as the organization’s medical officer, is not leaving, she said, though he plans to retire in July of 2015, which is when some of Health Share’s federal startup funding runs out. The new part-time officer will work alongside Labbey until then, though.   “We haven't yet made an offer but we are very close,” Meyer said.   Council member Amy Anderson asked Meyer about a benefit that would allow coverage for in-home support for Oregon Health Plan patients with mental health diagnoses, specifically for people with dual diagnoses.   “What are we going to do with dual eligibles? I've been at this a month. Every single agency I've called says no Medicare. I say no it's Care Oregon Prime,” Amy Anderson said, referring to her own efforts to find a mental health provider and in-home support for her partner.    Chief operating officer Susan Kirchoff said new enrollees will receive a postcard welcoming them to Health Share, telling them who their primary care provider is and how to get connected to care -- and that they will be automatically assigned to their county’s mental health authority.   Anderson said in Multnomah County, there really isn’t a mental health authority to speak of: “When you say, 'Go to your local mental health authority,' there isn't one. What you've got is the crisis line. I'm sorry, there isn’t one.”   Council member Gary Cobb and Kirchoff discussed the possibility of connecting patients to mental health care through their primary care providers -- and also said that mental health providers may even be designated as medical homes for patients who’ve received behavioral health but not physical health care for several years, in much the same way a person with a serious chronic health condition might identify a specialist as their primary provider.   In addition, council member Ryan Skelton -- a licensed clinical psychologist -- pointed out that smaller providers like himself are still largely unaware of how to connect with coordinated care organization.    “No one is reaching out to [small] providers on these kind of issues,” Skelton said.   During her presentation, Kirchoff talked about member placement in general, touching on the fact that historically, a person doesn’t become a patient at a clinic until they take the initiative to make an appointment. Now Health Share is mulling ways to make sure clinics reach out to patients to make sure they’re able to get in for appointments, provide appropriate screenings for long term conditions and make sure those needs are met. That process should include identifying barriers to accessing primary care, including transportation.   “We really want to focus on the key barriers and the key agencies to get those started,” Kirchoff said.   Anderson said when she first started accessing primary care services eight years ago at the Multnomah County Health Department, her first visit was an hour long visitation with an intake worker, which served as a “softening point” that made her feel like her needs were respected and understood. She urged increased or continued use of social workers for initial intake for patients who have not accessed healthcare in a long time.   “The time that person took was what it took to get me out of de-compensation mode. Social worker who could understand my situation -- that initial relationship with somebody who always understands you,” Anderson said.   Christen can be reached at [email protected].