Behavioral health is one of the most critical issues facing the Medicare population. According to the American Psychological Association, one in four older adults experiences a mental health problem such as depression, anxiety, schizophrenia or dementia. In addition, substance abuse among older adults is rising. The National Council on Aging estimates that the number of older adults with substance abuse problems, including alcohol misuse, is expected to double to five million by 2020.
With this in mind, the Lake Superior Quality Innovation Network—the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) serving Michigan, Minnesota and Wisconsin—is working to increase the number of clinics that are screening patients for depression and alcohol use disorders during primary care visits.
“Older adults experiencing depression often have a harder time managing other chronic conditions that diminish their overall health,” said Jane Gendron, program manager with the Lake Superior QIN in Minnesota. “Screening for behavioral health issues is a critical first step towards treatment.”
In Minnesota, the Lake Superior QIN recruited more than 200 clinics within 18 health systems in both rural and urban areas to participate in its behavioral health screening and reporting initiative. The clinics are leveraging electronic health records (EHRs)—instead of Medicare claims data—to reduce the burden of reporting and optimize the timely collection and use of data.
"Older adults experiencing depression often have a harder time managing other chronic conditions that diminish their overall health. Screening for behavioral health issues is a critical first step towards treatment.”
“Using EHRs to track when screenings occur provides them with real-time data that support physicians’ efforts to consistently identify behavioral health issues,” added Gendron. “Because data collection is more timely, it allows health systems to monitor the impact of process changes and improve more rapidly.”
Since not all EHR systems work the same, Lake Superior QIN staff help clinics identify necessary modifications. These changes let clinics capture clinically relevant data to show whether their efforts increased rates of screening for patients.
These efforts are paying off. In 2016, 69% of Medicare beneficiaries seen in participating primary care clinics in Minnesota received depression screenings, surpassing the 25% goal set by the Centers for Medicare & Medicaid Services. While complete screening data from 2017 won’t be available until July 2018, Lake Superior QIN saw a similar upward trend in depression screenings that year. Moving forward, the QIN-QIO aims to extend its learnings from depression screening to support increased screenings of Medicare beneficiaries for alcohol misuse.