Early Psychosis Intervention Clinic, New Orleans (EPIC-NOLA): Paying for care in an underserved area.
Poster A115, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron
Ashley Weiss, D.O., MPH1,2, Vinod Srihari, M.D.3,4, Serena Chaudry, LCSW2; 1Department of Psychiatry, Tulane University School of Medicine, New Orleans, LA, USA, 2Early Psychosis Intervention Clinic (EPIC-NOLA), New Orleans, LA, USA, 3Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA, 4Program for Specialized Treatment Early in Psychosis (STEP), New Haven, CT, USA
Purpose: Despite evidence of overall economic benefit, and federal initiatives supporting Coordinated Specialty Care (CSC) for early psychosis, implementation in the U.S. settings is limited by fragmented funding systems. While public-academic collaborations have hosted pioneer CSCs, commercial insurance providers need to be more fully engaged as essential stakeholders to scale up CSC. EPIC-NOLA is a new CSC designed with a diverse reimbursement model that will inform this next step in dissemination. Methods: After reviewing various CSC implementations, formal consultation was sought from the STEP Program (New Haven), which has tested a resource efficient CSC within a public-academic collaboration. EPIC-NOLA then forged a partnership between a for-profit agency and Tulane University’s Department of Psychiatry. The agency re-allocated 2 part-time licensed clinicians and contracted psychiatry services form Tulane University for this new CSC. The agency provided billing services aimed to maximize reimbursements from commercial and governmental insurance plans. Results: EPIC-NOLA launched on August 1, 2015 and offers CSC adapted to local needs. The clinic has accepted 15 patients for care. The payor mix is 33% commercial insurance and 66% Medicaid. We will present six-month data on selected clinical outcomes, with analyses of costs for provision of care versus reimbursement stratified by payor. Conclusion: EPIC-NOLA is piloting a commercial-academic partnership, to optimize a mixed-payor model, while retaining the ethos of CSC. The project will deliver salient data for a sustainable approach to disseminate early intervention in the U.S.
Topic Area: First Episode Psychosis