0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Columns   |    
Best Practices: The Washington Heights Community Service Model: Positive Outcomes and Implications for Reimbursement Under the ACA
Dianna Dragatsi, M.D.; Jean-Marie E. Bradford, M.D.; Claire C. Holderness, M.D.; Karen McKinnon, M.A.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300519
View Author and Article Information

The authors are affiliated with the Department of Psychiatry, Columbia College of Physicians and Surgeons, and the Washington Heights Community Service of the New York State Psychiatric Institute, New York City (e-mail: dragats@nyspi.columbia.edu). Marcela Horvitz-Lennon, M.D., M.P.H., is editor of this column.

Copyright © 2014 by the American Psychiatric Association

Abstract

Medicare and the Affordable Care Act (ACA) base reimbursement partly on hospital readmission rates, but there is little guidance for providers to reduce these rates. This column describes a model of care used by Washington Heights Community Service (WHCS) in New York City. Without benefit of external funding, WHCS has implemented practices, such as family involvement at all treatment levels, community outreach, effective medication prescribing, shared electronic medical records, and proactive provider communication, that have led to lower rates of readmission in addition to low rates of admission and emergency room use and a high rate of outpatient follow-up—all particularly relevant in this era of ACA mandates.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

+

References

Improving the Health Insurance Marketplace: Patient Navigators. Chicago, American Medical Association, 2012. Available at www.ama-assn.org/resources/doc/market-reforms/patient-navigators.pdf
 
Hyland  M;  Hoey  W;  Finn  M  et al: Reducing 28-Day Readmissions Project. Sydney, Australia, National Mental Health Benchmarking Project, 2008. Available at amhocn.org/static/files/assets/e16ae3dc/Adult_28_day_readmission.ppt
 
Kent  S;  Yellowlees  P:  Psychiatric and social reasons for frequent rehospitalization.  Hospital and Community Psychiatry 45:347–350, 1994
[PubMed]
 
Axelrod  S;  Wetzler  S:  Factors associated with better compliance with psychiatric aftercare.  Hospital and Community Psychiatry 40:397–401, 1989
[PubMed]
 
Olfson  M;  Mechanic  D;  Boyer  CA  et al:  Assessing clinical predictions of early rehospitalization in schizophrenia.  Journal of Nervous and Mental Disease 187:721–729, 1999
[CrossRef] | [PubMed]
 
Rabinowitz  J;  Lichtenberg  P;  Kaplan  Z  et al:  Rehospitalization rates of chronically ill schizophrenic patients discharged on a regimen of risperidone, olanzapine, or conventional antipsychotics.  American Journal of Psychiatry 158:266–269, 2001
[CrossRef] | [PubMed]
 
Corrigan  PW;  Angell  B;  Davidson  L  et al:  From adherence to self-determination: evolution of a treatment paradigm for people with serious mental illnesses.  Psychiatric Services 63:169–173, 2012
[PubMed]
 
Hansen  LO;  Young  RS;  Hinami  K  et al:  Interventions to reduce 30-day rehospitalization: a systematic review.  Annals of Internal Medicine 155:520–528, 2011
[CrossRef] | [PubMed]
 
Finnerty  M: The Quality Concern: Behavioral Health Inpatient Readmissions. Albany, New York State Office of Mental Health, 2012. Available at www.omh.ny.gov/omhweb/psyckes_medicaid/initiatives/hospital/learning_collaborative_2013/Quality_Concern.pdf
 
Boyer  CA;  McAlpine  DD;  Pottick  KJ  et al:  Identifying risk factors and key strategies in linkage to outpatient psychiatric care.  American Journal of Psychiatry 157:1592–1598, 2000
[CrossRef] | [PubMed]
 
Dixon  L;  Goldberg  R;  Iannone  V  et al:  Use of a critical time intervention to promote continuity of care after psychiatric inpatient hospitalization.  Psychiatric Services 60:451–458, 2009
[PubMed]
 
Tomek  L;  Lamberti  JS:  Using telemedicine to coordinate inpatient and outpatient psychiatric care.  Psychiatric Services 63:94, 2012
[CrossRef] | [PubMed]
 
Zilber  N;  Hornik-Lurie  T;  Lerner  Y:  Predictors of early psychiatric rehospitalization: a national case register study.  Israel Journal of Psychiatry and Related Sciences 48:49–53, 2011
[PubMed]
 
Auffarth  I;  Reinhard  B;  Dietrich  D  et al:  Length of psychiatric inpatient stay: comparison of mental health care outlining a case mix from a hospital in Germany and the United States of America. German Journal of Psychiatry 11:40–44. 2008
 
Boaz  TL;  Becker  MA;  Andel  R  et al:  Risk factors for early readmission to acute care for persons with schizophrenia taking antipsychotic medications.  Psychiatric Services 64:1225–1229, 2013
[CrossRef] | [PubMed]
 
Chisholm  D;  Gureje  O;  Saldivia  S  et al:  Schizophrenia treatment in the developing world: an interregional and multinational cost-effectiveness analysis.  Bulletin of the World Health Organization 86:497–576, 2008
[CrossRef]
 
Voices of Recovery.  New York,  New York State Psychiatric Institute, Center for Practice Innovations. Available at practiceinnovations.org/ConsumersandFamilies/ViewAllContent/tabid/232/Default.aspx
 
References Container
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Articles
Books
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 32.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 33.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 33.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 33.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 32.  >
Topic Collections
Psychiatric News
APA Guidelines