When did the health of the mind and teeth get pulled out from health care for the body?
Many people are used to going to clinics and hospitals for physical health care and to dentists and mental health professionals separately.
But “the way we’ve always done it” creates major obstacles to getting the care patients need.
Consider a patient in the current system:
“Mary” is a victim of the economy. After a lifetime of work, she’s now living in poverty. She has no insurance to care for her unmanaged asthma, tooth decay and depression.
Luckily, Mary qualifies for Medicaid so she visits a primary care provider who accepts Medicaid patients. The clinic schedules tests for asthma, but doesn’t do dental care. And in the brief, 15-minute visit, it’s possible that Mary’s depression never makes it into the conversation.
In some clinics, Mary faces many more risks:
• That no one at her health plan or clinic discovers she hasn’t cared for her asthma properly and she ends up in an emergency room.
• That her dental health is not attended to and it threatens her overall health.
• That her undiagnosed, untreated depression contributes to her inadequate response to her health needs and to spiraling lifestyle choices harmful to her physical and mental well-being.
The current system includes multiple barriers to joint care management for mental, physical and oral health. But the Oregon Legislature is designing a better, integrated system. In the proposed system, Mary could expect this alternative journey:
Mary gets a welcome call from the Coordinated Care Organization (CCO) in her community. She learns she has a single plan for her physical, dental and mental health needs, and a team that coordinates her care.
Before long, she’s talked with a behavioral health specialist who assesses her depression and schedules follow-up. She’s had an oral health inspection and cleaning. And she has talked with a nurse practitioner who has reviewed her clinic visit and has scheduled asthma tests at the most convenient time for Mary.
The CCO health navigator, who is collaborating with Mary and her providers, follows up with a reminder call for her next visits.
Mary is a fictional creation, but thousands of Oregonians share her story. Some Federally Qualified Health Clinics and others do offer coordinated care already, but it isn’t the standard for all providers.
Integration of health services is actually a very straightforward concept: Build a person-centered health system that does not separate the mouth and the mind from the body.
We applaud the legislature for working to create a system that puts the needs of the patient first, at the center of care. By treating the whole person, we will improve the health of the whole community.
The CareOregon Member Advisory Council
Maria Morrow, Chair
Brenda Berger
Mike Morgan
Maddie Mettler
Charles Robertson
Sele D’Amato
Mahin Asgaris
Nancy Judkins
Judith M. McClenny
Diane Myers
