Frequently Asked Questions

Can complexity-based integrated services add value in patient-centered medical homes and accountable care organizations?

To date, few have considered that more effective mental condition care, which is integrated with general medical assessment and treatment, could contribute substantially to the value proposition both in PCMHs and ACOs. Fifty to eighty percent of patients seen in primary care have either presenting or concurrent mental health issues. Up to a third will have mental conditions that, at least, double health services costs. In those with chronic medical conditions, untreated or poorly treated mental conditions predict medical treatment non-response, personal impairment, and two to five times higher annual health service use and cost.

If accountable care organizations (ACOs) are to achieve their desired goal of achieving measured quality improvements while reducing the rate of health care spending growth, then augmenting health care value, i.e., providing patients with the greatest “needed” health benefit within maximized cost parameters (Value = Benefits/Costs), will be a key undertaking. Including the integration of mental condition care with medical assessments and treatment in patient-centered medical homes (PCMHs), which are a core component of ACOs, and providing integrated case management for patients in the ACO with health complexity has the potential to substantially reduce total health costs.

The Table below illustrates annual spending for chronically ill medical patients with and without mental health comorbidity. If only 10% of the cost gap were closed through integrated service delivery and support, total cost of care for 1,000 patients with arthritis would be reduced by $0.5 million, for patients with migraine $0.6 million, for patients with diabetes $0.7 million, and obstructive lung disease $0.7 million. These savings are far in excess of the cost of personnel providing integrated services leading to significant return on investment.

Annual Total Health Costs for Chronically Ill Patients with and without Mental Health Comorbidity

For more information or to set up an appointment contact: Mary Kathol, Director of Project Implementation.

Cartesian Solutions, Inc.™
3004 Foxpoint Rd. - Burnsville, MN 55337
Phone: 952-426-1626 - Fax: 952-426-1200
E-mail: integration@cartesiansolutions.com