Rancho Cucamonga, CA, November 3, 2017 — Inland Empire Health Plan (IEHP) has won an Innovation Award for improving the health of low-income members through a program that coordinates their complex physical and behavioral health care needs across the healthcare system in Riverside and San Bernardino counties.
The annual Innovation Award, bestowed by the California Department of Health Care Services (DHCS), honors creative interventions by Medi-Cal health plans that seek to improve the quality of their members' healthcare. The goal is to highlight health plans' best practices.
"Many IEHP members who have a chronic medical condition coupled with either a mental health or substance abuse disorder have been receiving fragmented care that has not adequately addressed their behavioral health needs," said IEHP Chief Medical Officer Jennifer Sayles, MD. "This program integrates care across multiple providers and healthcare systems, improving members' health outcomes while reducing their use of emergency rooms and urgent care clinics."
IEHP's Behavioral Health Integration and Complex Care Initiative (BHICCI) provides funding to 12 healthcare organizations with 30 participating clinics throughout the Inland Empire. The organizations develop integrated, multidisciplinary care teams to care for the most complex patients served by these primary care, behavioral health, and specialty clinics. The complex care team is comprised of four core members: a behavioral health clinician, a nurse care manager, a care coordinator, and a primary care physician champion. Together the team manages and cares for a caseload of people with complex needs including co-occurring chronic medical, mental health, and/or substance use conditions.
Other innovative aspects of the BHICCI include the assignment of Practice Coaches to facilitate and provide support for core practice changes; the use of data analytics, including predicative risk modeling, to stratify each clinic’s patient population and identify the most complex or high-risk individuals; the use of a registry to collect and monitor physical and behavioral health outcome measures and to serve as a clinical support tool and help team members quickly identify people who aren’t improving as expected and where intervention is needed; the development of a treat-to-target substance use assessment approved by DHCS for use as a Medi-Cal approved substance use screening tool; the inclusion of patient experience and care team experience surveys and goal-setting sessions to assess and understand the initiative’s impact on two of the four quadruple aims, patient and workforce satisfaction.
Between January 1, 2016 and June 2, 2017, program participants showed a significant decrease in blood pressure and depression (as measured by the PHQ-9 screening and diagnostic tool for mental health disorders). "The BHICCI is an example of IEHP’s mission to develop innovative ways to meet challenging healthcare needs," said IEHP Chief Executive Officer Bradley P. Gilbert, MD. "We are honored to be recognized by DHCS for this program, which is so critically needed by our members."
IEHP's entry was one of 18 nominations from 12 Medi-Cal Managed Care Health Plans throughout California. This is the second time IEHP has received the Innovation Award since DHCS introduced it in 2015.
IEHP, Inland Empire Health Plan, is a not-for-profit Medi-Cal and Medicare health plan located in Rancho Cucamonga, California. With a network of more than 6,000 providers and more than 2,000 employees, IEHP serves more than 1.25 million residents in Riverside and San Bernardino counties who are enrolled in Medi-Cal or Cal MediConnect Plan (Medicare). Through a dynamic partnership with providers, award-winning service and innovative products, IEHP is fully committed to providing members with quality, accessible and wellness based healthcare services. www.iehp.org.