NOTE: Photo TBD
Peer Support Services: an Emerging Resource for Health Reform
• Recovery Oriented Services
Enhanced Consumer Centric Directed Care
• Improve and enhance the existing Peer Specialist/Recovery Services
– Data currently within Optum services demonstrate a nearly 40% reduction in in-patient hospital stays
– Peer specialists also demonstrate consistently that the members they serve are more engaged in their
local community support activities
• Behavioral/Medical Integration Opportunities
– As a result of a demonstration project in San Antonio, Texas we found that a Whole Health Peer
Coach can successfully engage members that are resistive and help them to address both their
medical/physical issues as well as their mental health or substance use issues.
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum.
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Components of the Whole-Health Peer Specialist Program
• Assessment of the need for this service
• Criteria for admission to the program
– 60 years of age or older
– Two hospitalizations in the prior year
– Diagnosed with both a mental health issue and a general
health issue
• Willingness to develop a relationship with our Whole-Health
Peer Specialist (WHPS)
• Contract established with an elder care provider to administer
the program
– Provider in conjunction with Optum search and locate
the Peer Specialist
for this project
– Referrals were offered to provider by Optum
Peer Whole-Health Specialist
•
A specially trained advocate who has actually
experienced mental illness as well as having a
physical health issue
• Training includes standard Peer Specialist Training as
well as an additional component to deal with the
physical health issues
• Understands the impact such illness can have on a
person’s physical and emotional well-being
• Does not diagnose or treat any medical issues
• Does help a mental health consumer who is dealing
with physical health conditions develop recovery goals
• Offers support in following the care and wellness
treatment plan created by the consumer and the
treating clinician
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum.
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Program Launch
• Project launched September 1, 2010
• WHPS starts to engage referrals
• WHPS works with between 18 and 22 individuals
• Both in-person and phone contact regularly established
with program participants
• Relationships develop
Findings
• Some referrals easy to engage and willing
to participate in the program
• Others required several phone
conversations with WHPS prior to
willingness to participate in the program
• Common finding with all participants the
WHPS needs to share their experiences
with both mental health issues as well as
general health issues
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum.
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Case Study: Mrs. V
1.
Initially, when the Whole Health Peer Specialist met with Mrs. V she had been in
and out of the hospital several times for treatment of depression.
2.
Her self-esteem was very low, and she did not believe that her life could get
better. When the WHPS commented that it is possible for her to find recovery,
Mrs. V cried.
3.
She said that she had never been told that "Recovery is Possible" and it was hard
for her to believe, because she had no hope.
4. Midway through the program, Mrs. V was re-hospitalized again for depression.
5. With treatment and working with the WHPS, her life gradually began to improve and
she became able to manage her medication and make all doctor appointments.
6. Her husband Mr. V is very supportive of his wife, and they have a strong
relationship.
7. At Mrs. V’s request the WHPS was able to help her sort through her mail and coach
her on responding to correspondence by assisting her with writing letters or making
phone calls.
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum.
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Outcomes
The program has assisted to decrease hospitalization rate by 70%
Length of stay prior to entry to program: 6 days
Length of stay after entry to program: 2.3 days
Participants engaged in their local communities
Participants willingly call WHPS as needed
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum.
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Thank You and Questions?
Peter C. Ashenden
Director of Consumer and Family Affairs
1-708-749-7396
peter.ashenden@optum.com