APM 2013 Annual Meeting

Moderator: Wayne Katon, MD, University of Washington School of Medicine
Presenters: Lorin M. Scher, MD, University of California, Davis School of Medicine, Sacramento, CA; Lori Raney, MD, Axis Health Center, Durango, CO; John Kern, MD, Regional Mental Health Center, Merrillville, IN; David Liu, MD, University of California, Davis – Sacramento CA

Integrated models of care are gaining momentum within our large and heterogeneous health care system for a variety of reasons: 1) improved patient outcomes 2) decreased health care utilization 3) preparation for Affordable Care Act reimbursement. However, health systems and physicians often encounter funding barriers when attempting to develop such programs.

This symposium will discuss these "real-world" funding barriers encountered when setting up integrated models of care in different health care settings (academic medical center, county setting, non-profit health systems, etc).

Dr. Katon will moderate the session, and presenters will discuss their roles in overcoming these funding barriers in different states and regions (California, Colorado, Indiana, Washington State).

Dr. Raney, chair of the APA Workgroup on Integrated Care, will discuss her role as Medical Director of a non-profit CMHC in Durango, Colorado. Dr. Raney has funded her integrated care projects through FQHC expansion grants, as well as state and local grants. She will also discuss how funding streams may exist for such projects with Affordable Care Act (ACA) support.

Dr. Scher will discuss his role as a faculty psychiatrist in developing integrated programs at an academic medical center (UC Davis Health System). In collaboration with the department of Chronic Disease Management, Dr. Scher received 2 pilot grants before securing health system funding to expand into all 16 UC Davis Primary Care Clinics (PCNs). He will discuss the importance of strategic collaborations, including securing PCP, medical director and administrative “buy-in” within an academic medical center.

Dr. Kern will discuss his role as the Chief Medical Officer of a large non-profit CMHC in Merrillville, IN. Dr. Kern has been involved in multiple integrated projects over the last 6 years, using an IMPACT model to improve behavioral outcomes in primary care populations, and directing a PBHCI grant to improve health outcomes in populations with serious mental illness. He will discuss the financial and institutional relationships between his CMHC and a FQHC to implement and fund this integrated work. Dr. Kern will discuss his plans to maintain financial stability by applying for FQHC status within his own system.

Dr. Liu will discuss his role as a psychiatrist within a county system (Sacramento County Mental Health) in developing integrated programs. With the support of a state-funded grant, Dr. Liu will discuss the challenges of integrating primary care and psychiatry within a complicated county system and a deeply engrained medical culture.