Health Plans

Behavioral Health Departments within a Medical Managed Care Company

Create Value by Incorporating Behavioral Health Service Integration into Medical Business Practices

Mental health professionals are a core part of transitioning to an integrated system and a critical talent pool for implemented integrated programs. However, the organizational structure through which contributions are made and services are provided by mental health clinicians and administrators will necessarily change. Mental health personnel in all health plan divisions will be called upon to learn about physical health work processes and to collaborate with non-mental health specialists as new approaches to the coordination of services are built. Non-mental health personnel will also learn about and compare their own work processes to those of behavioral health. Together mental health and non-mental health leadership and staff will determine new integrated work flows that capture the greatest benefit for members in an environment that supports coordinated general medical and mental condition services. Interdisciplinary teams will create a new value-based single process through which total health for members is a primary objective. The ultimate outcome should be efficient, comprehensive, and unified support for medical and mental health services to members as long as participatory mental health professionals are involved.

If one of these describes your situation...

• Consolidation of physical and mental health service support is being considered by the general medical health plan
• A decision has been made to make behavioral health care management support and claims adjudication part of physical health business practices

...Ways that Cartesian Solutions, Inc.™ can help

• Educate staff about what they should expect and how their active participation can augment mental condition care and outcomes in a significantly larger number of members with mental conditions
• Provide training in cross-disciplinary work processes and common medical illnesses
• Assist in thinking through the organizational transition of mental condition service support with physical health service support to insure total health outcome improvement
• Provide training in integrated case management

The traditional segregated approach to behavioral health management was built on the flawed premise that mental conditions and their treatment have little impact on or relation to physical health problems. Indisputable evidence now shows that untreated or poorly treated mental conditions is associated with worse medical outcomes and substantially higher health care costs. While transition to an integrated physical and mental health administrative structure will require fundamental change in health plan business practices, the end result will be improved total health for patients and lower total cost of health care, especially for those with chronic medical and psychiatric conditions and those with health complexity.

During this process, quality leadership and staff from both the physical health and mental health sides of health plan business will be called upon

• To partner with cross-disciplinary colleagues performing similar tasks
• To learn about alternative ways to support the components of support for health care delivery in which they are involved
• To collaboratively create a new and integrated health plan environment
• To develop the attendant skills necessary to support improved comprehensive health for members.

At the completion of the integration process, both medical and mental condition personnel should be winners. They will have expanded their ability to support total health for discrete members with comorbid and/or complex conditions through integrated health plan business practices. Both will retain importance to the health plan, but now through their ability to coordinate and support physical and mental condition services.

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