Thursday, April 24, 2014
When the people at Maine Mental Health Partners went shopping for an information technology system that would integrate patient treatment and billing records between half a dozen affiliated agencies, they were hit with a surprise.
There is no such thing.
That lack illustrates the challenge faced by the Maine consortium's attempt to coordinate services for people with mental illness, bringing community education, peer support, drop-in counseling and crisis intervention hospitalization all under the umbrella of one organization. It also creates the hope that what is coming together in southern and coastal Maine could be a model for mental health treatment, both within Maine and across the nation.
The problem with the hodge-podge of public and private agencies that we call our mental health care system is usually described as "fragmentation." The reality is that it is not a system at all.
One consumer can receive services in a variety of settings, but the providers may have no idea what the others are doing. That leads to ineffective and wasteful care, or worse. It creates an opportunity for a patient to fall through the cracks and receive no treatment at all.
Maine Mental Health Partners, a private nonprofit owned by Maine Health, the parent of Maine Medical Center, is trying to build a system with fewer cracks to fall through. Through its affiliated agencies, which include Spring Harbor Hospital, Community Counseling and Mid-Coast Mental Health, the organization creates a web of services that share information with each other.
Such a system has the opportunity to provide care less expensively, which is important as state money grows more scarce every year.
The organization has consolidated its back-office functions, creating economies of scale by joining human resources, finance and billing for all the affiliated groups.
This coordination has attracted the attention of health insurance companies, and one, Anthem, is experimenting with bundling services, or paying a set amount to manage a patient's care rather than reimbursing the provider for each service that's delivered. Maine Mental Health Partners is betting that it can provide coordinated services for less than fragmented ones, and in many cases they are probably right.
Just as in the rest of the health care system, bad care is often more expensive than good care and too many services are less effective than just the right amount. That's why structures like what's being built by Maine Mental Health Partners will be so important to the future of mental health services in this state and beyond.