Presentation given at recent HSJ mental heath service quality conference

1. Commissioning for Outcomes in Mental Health Jon Allen – Director of Mental Health, UHUK And Dr David Whitehouse – Chief Medical Officer Strategy and Innovation, OptumHealth

8. Commissioning for Outcomes in Mental Health Using outcomes from evidence based research to focus commissioning plans and priorities Once a strategic outcome is identified the tactical approach, the specific level of achievement and methods of measurement and likely costs need to be defined as part of the operational plan Depression symptoms of people with depression in work reduced to an adjusted average of 8.9 on QUIDS – SR scale Effective weekly hours worked by people with depression to be on average 29.5 hours per week within 12 months of treatment Wang PS, Simon GE, Avorn J, et al. Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial. JAMA 2007;298:1401 11. Reduce days lost to work because of depression Individual placement and support programmes are more effective than standard vocation and rehabilitation services increase number of people on CPA working for at least one day in the year by at least 16% Burns T, Catty J, Becker T, et al. The effectiveness of supported employment for people with severe mental illness: a randomised controlled trial. Lancet 2007;370:1146–52. Inrease employment of service users on CPA Anticipated outcome Evidenced based intervention /service Desired Mental Health Outcome

14. Commissioning for Outcomes in Mental Health Using outcomes to monitor and evaluate service delivery – OptumHealth Facility Quality Management

15. Commissioning for Outcomes in Mental Health Using outcomes to monitor and evaluate service delivery – OptumHealth High readmission rate & Inefficient Ok with regard to readmission rate BUT Not v. efficient

16. Commissioning for Outcomes in Mental Health Using outcomes to monitor and evaluate service delivery – OptumHealth CT Facility Quality 2008 CT facilities compared for: Readmits % of appts scheduled in 7 days % of f/u appts kept in 7 days

17. Commissioning for Outcomes in Mental Health Using outcomes to monitor and evaluate service delivery – OptumHealth Care Advocate Interventions Encounter Data Automated Clinician ALERT Messages 4-month Follow-up Wellness Assessment Questionnaire Measuring Sustainable Outcomes Required High-Risk Wellness Assessment Questionnaire between visits 8 & 10 And/Or PROPRIETARY ALGORITHMS Modified Member Questionnaire (Wellness Assessment) + Increase Frequency to Measure Treatment in Progress 1 & 3–5 New Generation ALERT® Model

22. Depression CHF Medical Cost Medical Cost Depression Diabetes Depression Arthritis Medical Cost Depression Cancer Medical Cost Commissioning for Outcomes in Mental Health Using outcomes to monitor and evaluate service delivery – OptumHealth Predictive Model Demonstrates the Effect of Depression on medical costs