Overview

In 2016, the Robert Wood Johnson Foundation launched the Systems for Action Research Program to test new mechanisms for aligning medical, social, and public health delivery systems to improve health and health equity. The Arizona State University received funding as one of the Systems for Action Research Centers and the focus of this project has been on health care, criminal justice, and social services coordination of individuals with mental illness and/or substance use disorders.

This presentation describes the ASU project and presents preliminary findings. Medicaid claims data for a large urban community in the southwest US was analyzed for a population of approximately 350,000 claimants. Using multisector databases including hospital discharges, Medicaid claims, jail bookings, correctional health services, probation supervision, homeless management information system, law enforcement, the court system, and social service agencies, we simulate a future state of better alignment to create a coordinated delivery system for behavioral health disorders with an improved impact on health, well-being and equity for the population.

We use these data to compare patterns of care for physical health and severely mentally ill (SMI) patients as well as understand their respective determinants. We next apply these data to a multisector analysis to better understand the sequential intercept model to better align care processes and outcomes. To date, a multisector group of stakeholders, representing more than sixty individuals and organizations within Phoenix has been convened. Preliminary analysis has involved investigating how multisector services, delivery systems, and financing streams are currently aligned as well as their gaps.

Our findings provide a multisector analysis that follows patients across various treatment settings, law enforcement interventions, through the court system and final resolution including probation, incarceration, or discharge to the community. We also present distributions and frequencies associated with the sequential intercept at various stages in the process.

Very little research has been undertaken to understand multisector patterns and care utilization that includes healthcare, law enforcement, social service agencies, public health, and the court system. This is among the first research studies to assemble and match multisector cost and utilization.

Details

Project: Financing and Service Delivery Integration for Mental Illness and Substance Abuse
Resource: Download Slides
Authors: Riley WJ, Runger G, Hartoonian G, Shafer M, Love K