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Aetna’s Primary Care Based Behavioral Health Program Hyong Un, M.D. Chief Psychiatric Officer

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Aetna’s Primary Care Based Behavioral Health Program Hyong Un, M.D. Chief Psychiatric Officer. CHFA Annual Meeting 2011. We Are in a Dynamic Time. Economic Conditions. Political Environment. Customer Needs. Health Care System. Forces Driving Our Strategy. Well-being/Wellness - PowerPoint PPT Presentation

Text of Aetna’s Primary Care Based Behavioral Health Program Hyong Un, M.D. Chief Psychiatric Officer

Aetna’s Primary Care Based Behavioral Health Program Hyong Un, M.D. Chief Psychiatric OfficerBehavioral Health Program
Hyong Un, M.D.
Chief Psychiatric Officer
Economic Conditions
Political Environment
Customer Needs
Health Information Technologies
*
Health System Forces
*
1970
2009
2018
$75B
$4.2T
$2.5T
Cost shifting
Chronic Health Conditions Underlie
Top
1%
Top
5%
Top
10%
Top
15%
Top
20%
Top
50%
Bottom
50%
% of HC Spending
(≥$39,688)
(≥$13,387)
(≥$7,509)
(≥$5,191)
(≥$3,733)
(≥$724)
(<$724)
Source: Kaiser Family Foundation calculations using data from U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS), 2004.
Diabetes
Note: Dollar amounts in parentheses are the annual expenses per person in each percentile. Population is the civilian noninstitutionalized population, including those without any health care spending. Health care spending is total payments from all sources (including direct payments from individuals, private insurance, Medicare, Medicaid, and miscellaneous other sources) to hospitals, physicians, other providers (including dental care), and pharmacies; health insurance premiums are not included.
Source: Kaiser Family Foundation calculations using data from U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS), 2004.
Chart1
Prevalence of Depression and Chronic Mental Illness
Pincus HA. J Clin Psychiatry. 2001;62 Suppl 6:5-9; Schatzberg AF. J Clin Psychiatry. 2004;65 Suppl 12;3-4.
Medical Condition
Sheet2
0.909
0.091
Sheet3
Diabetes
27%
Asthma
45%
Stroke
40%
MI
40%
*
Source: HERO Study. Goetzel et. al
*
Behavioral Health in Primary Care
Significant portion of primary care visits are associated with stress, lifestyle management or a psychological disorder
Behavioral health disorders are often under-diagnosed
Screening tool availability/reimbursement alone are insufficient
Behavioral health support is required for optimal treatment
*
Prescribing patterns by provider type
*
Employee Assistance Program
Specialized Behavioral Health Service
Addresses behavioral health, health/wellness issues
Facilitates access to behavioral health services
Brief/problem-solution focused intervention
Referral /continued treatment outside PCP office if needed
*
Identify behavioral health practices
*
Including Jefferson University & University of Pennsylvania primary care
Pediatric practices
Including Children’s Hospital of Philadelphia location
Includes reimbursement for pediatrician screening and pediatrician/psychiatrist telephonic consultations
27%
45%
40%
40%
52%
Diabetes
Asthma
Stroke
MI