Advancing Rural Health System Transformation Conference

Health care in Maine is a conundrum—especially for rural communities. On the one hand, the health care sector is the state’s largest source of jobs, and in many rural counties, health care makes up a disproportionally higher share of overall employment. The health care sector provides many meaningful opportunities for employment for rural community members. On the other hand, issues like the lack of access to affordable care, the shortages of health care providers, the rapid changes in health care payment and delivery, can take their toll on the quality of life in rural communities.

This health care conundrum is driving rural businesses, educators, providers, municipalities, payers, and other stakeholders to consider how the current system might evolve. That’s why the Maine Health Access Foundation (MeHAF) has begun an effort to assist rural communities to assess and promote ideas and strategies for improving rural health systems. Toward that end, MeHAF hosted a conference on Advancing Rural Health System Transformation on November 10, 2016 at the Cross Center in Bangor with over 100 people in attendance.

Thriving in Place Fact Sheet

MeHAF launched its Thriving in Place (TiP) initiative to help persons with chronic health conditions (including the elderly and persons with disabilities) maintain or improve their health so they can remain safely in their homes and communities.  This document provides more information about the TiP initiative.

Reflections on MeHAF’s Payment Reform Grant Initiative

MeHAF funded 14 organizations starting in 2011 to work on projects focused on mitigating the increasing cost of health care through innovative payment reform strategies, ensuring that people who are uninsured and medically underserved were included in these efforts. Our goal was to fund projects that would preserve access, improve quality, and offer better value for our health care spending. We awarded nearly $3 million in three rounds of two-year grants to support this work during 2011–2014, and awarded several of the first round grantees an additional two-year grant of $75,000.

We learned a great deal from this grant initiative as a whole and from each grantee. In order to gain greater understanding of each grantee’s experiences, we interviewed the grantees in late 2014 to get their perspective on their own work and on the overall initiative.

This blog series highlights what we learned. Short video clips of grantee interviews are included to allow the grantees to directly share their insights and reflections.

State Approaches for Integrating Behavioral Health into Medicaid Accountable Care Organizations

This technical assistance tool examines four broad strategies states can use to integrate behavioral health services into ACOs: (1) incorporating behavioral health into payment models; (2) requiring ACOs to report on behavioral health metrics; (3) encouraging ACOs to include behavioral health providers; and (4) providing integration supports. It explores how eight states have incorporated these strategies into their ACO approaches.

Integrated Behavioral Health and Primary Care Evaluation

Between 2009 and 2015, MeHAF contracted for extensive qualitative and quantitative evaluation of the Integration Initiative (integrated behavioral health and primary care). Below are several of the evaluation reports. For more details, contact Becky Hayes Boober at bhboober@mehaf.org.

In 2005, MeHAF launched a 12-year, $14 million integrated behavioral health and primary care initiative. Almost half of Maine primary care practices now provide some level of integrated care. This document summarizes MeHAF’s efforts and lessons learned in the initiative.

Sustainability of Integrated Care

Sustainability of integrated care is a priority for MeHAF. Therefore, an independent survey and interviews were conducted with former grantees 12-18 months after their MeHAF funding ended to see which elements of integrated care were continued. Almost all grantees had continued integrated care, and many expanded it to new sites. They also reported the factors that facilitated continued integrated care practice.

Maine’s Integrated Care Cross-site and Systems Transformation Evaluation

Evaluation of MeHAF’s Integration Initiative conducted by John Snow Inc. included a cross-site examination of clinical practices and a review of systems transformation integrated care projects funded by MeHAF. Several of their reports are included here.

Key Informant Findings

Key nongrantee stakeholders across sectors that impact integrated care were interviewed in 2010 and 2014 to determine whether awareness of integrated care increased even among stakeholders not directly engaged in MeHAF integrated care grants.

Resources for Reimbursement of Integrated Behavioral Health and Primary Care

MeHAF continues to provide technical assistance for Maine sites wanting to implement, sustain, or improve the integration of behavioral health services and primary care. Guidelines developed for reimbursement and regulations follow.

Mary Jean Mork also has created voice-over PowerPoint presentations to provide guidance on implementing and financially sustaining integrated behavioral health and primary care. Please make certain your speakers are turned on when you open the PowerPoint. As soon as you start it as a slide show on full screen, the voice over function will begin.

Bridging the Digital Divide

This report summarizes the results of collaborative work groups that engaged consumers, behavioral and physical health providers, and other stakeholders to develop recommendations on integrating behavioral health information into electronic health records, develop greater consumer understanding and support of integrated health records, and to increase access to the statewide health information exchange.

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