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Spring 2013, Volume 21, Number 2

Missouri

A shocking fact is what led to Missouri's creation of a health home program for individuals with serious mental illness: the premature death rate of people with serious mental illness in the public mental health system.

"We found that the people we're serving were dying in their mid-50s, with 80 percent of those years of life lost related to chronic medical illness," said Joseph Parks, M.D., Chief Clinical Officer for the Department of Mental Health and Director of the Missouri Institute of Mental Health.

Based in community mental health centers, the state's health homes for people with behavioral health issues feature the key health home characteristics of comprehensive, coordinated care; health promotion initiatives; transitional care; referral to community services; and support for patients and families. Health information technology brings all information about an individual's care together in one place.

That means participating community mental health centers are focusing on individuals' physical health like never before, said Dr. Parks. Training has helped get staff once devoted exclusively to clients' behavioral health needs educated about physical conditions like hypertension and asthma, medications, and lifestyle change. The designated health homes now screen patients for weight, blood pressure, lipid levels, and other indicators of physical health. They also receive data on all of individuals' diagnoses, treatment, and medications, which they then use to identify gaps in care.

"If you think about it, your insurance company knows more about your care than any individual provider if you're going to two or three, but usually payers are the only ones who see that information," said Dr. Parks. "What we're especially proud of—and what other payers should do—is take all that information and make it available to the people providing treatment."

That approach is already paying off, not just in terms of improved health but in decreased costs, said Dr. Parks. "The early results show that the program saves more than it costs," he said, explaining that participants now cost about $160 less per month than before.

For more information, visit the Missouri Department of Mental Health's health home website Exit Disclaimer.

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