To have population-based counseling and wellness services integrated into the Grand Valley Health Plan Group Practice that targets high-risk members, focuses on behavior change, and effectively expands the number of members receiving services. 

• Percent Membership Seen by Counseling and Wellness Staff in Primary Care
• Percent Members Referred to a Behavioral Health Specialist
• NCQA HEDIS: Percent Members Receiving Ambulatory Mental Health Services per 1,000 Members per Year
• NCQA HEDIS: Antidepressant Medication Management – Percent Members Receiving Effective Acute Phase Treatment
• NCQA HEDIS: Antidepressant Medication Management – Percent Members Receiving Effective Continuation Phase Treatment
• NCQA HEDIS: Antidepressant Medication Management – Percent Members Receiving Optimal Contacts
• NCQA HEDIS: Percent Members Receiving Appropriate Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder Medication
• NCQA HEDIS: Follow-Up After Hospitalization for Mental Illness Within 7 Days and Within 30 Days
• NCQA HEDIS: Mental Health Inpatient Discharges per 1,000 Members per Year
• NCQA HEDIS: Members Receiving Mental Health Inpatient Services per 1,000 Members per Year

• Implemented co-location of Counseling and Wellness (C&W)  Staff (Behavioral Health Counselors and Dieticians) in all Grand Valley Health Plan (GVHP) Primary Care Centers and placement of their workstations alongside of primary care physicians'
• Established 15- to 30-minute appointments for C&W Staff to provide timely access for Members and Primary Care Physicians (PCPs)
• Established 50 percent of daily C&W appointments as same-day appointments
• Provided basic triage, assessment, consultation, and health counseling to members at their primary care center and to their PCPs
• Established evidence-based care guidelines for the delivery of C&W services
• Focused on services for traditional behavioral health and dietary issues, but also on lifestyle and behavior factors that impact members’ health and management of disease

With barriers to communication and coordination of care broken, medical and counseling and wellness services have been truly integrated. More members have access to and utilize the highest level of whole-person care. The positive outcomes support that integration improved care. GVHP continues to expand the C&W services to members with current focus on high-risk populations who can be better managed using this integrated care model.

• GVHP’s C&W Staff saw 26.7 percent of the total health plan membership in 2006
• Significantly improved PCP satisfaction with C&W services
• First in Michigan on all six Effectiveness of Care HEDIS Measures for Behavioral Health
• Tripled access and use of services by members in three years and established the national benchmark for members using ambulatory services for mental health (HEDIS – Use of Service Measure)
• Decreased GVHP’s mental health hospitalization rate by 54 percent since 2002

Barbara Luskin, Quality Manager
Grand Valley Health Plan
luskinb@gvhp.com

[Posterboard presentation at IHI's December 2007 National Forum]