VeriCare Initiative Responds to Medicare Policy Change; Behavior Medicine Programs Are Implemented Across the United States

SAN DIEGO, March 17 /PRNewswire/ -- When the U.S. Department of Health and Human Services approved Medicare coverage for health and behavior-based procedures to prevent, treat or manage physical health problems and chronic illness last year, VeriCare (http://www.VeriCare.com) responded by creating comprehensive behavior medicine services. The leading national provider of mental health services to the long-term care community, VeriCare has now implemented its Medicare-approved behavior medicine program nationwide.

"This change in federal policy represents a milestone in the overall healthcare of older adults whose medical conditions are often complicated or worsened by non-medical factors," said Dr. Joseph M. Casciani, president and co-founder of VeriCare. "Behavior medicine care can speed recovery from illness or injury, decrease the need for some medications, reduce the depression that accompanies chronic illness, and generally improve quality of life. The fact that Medicare recognizes the need for behavior-based services to older adults with medical illnesses is a major victory for older Americans and their caretakers."

In explaining the need for behavior medicine programs, Dr. Casciani cited research showing that in 1996, just 12% of Medicare beneficiaries accounted for a whopping 75% of Medicare's expenditures for medical care. Within that 12%, most suffered from one or more chronic illnesses like diabetes, congestive heart failure, coronary artery disease, pain, or respiratory disorders. Their illnesses were further complicated by behavior-based problems including poor medication compliance, lack of self-management skills, and resistance to adopt recommended lifestyle changes.

With 300 providers working in 1,000 long-term care facilities, VeriCare was well positioned to offer behavior medicine programs to Medicare recipients. The organization's programs are placed on-site for the convenience of residents, and all services are provided by licensed psychologists, psychiatrists or advanced practice nurses.

"Although the proportion of Medicare recipients in need of behavior medicine services is fairly low, these individuals have a profound impact on Medicare's overall expenditures," Dr. Casciani explained. "With programs available to address the behavioral complications of their physical condition, many of these people will be able to respond more favorably to their medical treatment. In the long run, that will mean substantial savings for Medicare."

ABOUT VeriCare

Formerly Senior Psychological Services, VeriCare was founded in 1991. The company is one of the country's leading providers of quality mental health care to older adults in skilled and residential settings. VeriCare currently provides a wide range of services in seven states nationally.

CONTACT:
Craig B. Grether, Ph.D.
VeriCare Management, Inc.
800-257-8715 ext. 131
cgrether@vericare.com
http://www.vericare.com

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Your Partner for Meeting the
Mental Health Needs of the Elderly

Welcome.

On these pages, you will learn more about our clinical programs and the delivery of quality mental health and behavioral health care to older adults. We encourage you to peruse the following pages. This will help you to develop an appreciation for our standards and ethical guidelines, and for the ways we conduct our business.
If you are looking for quality, convenience and professionalism in your mental health provider, Vericare wants to partner with you.

Our plans for this year will bring us into other states. If you are a facility, or if you are a part of a chain that is located in a state other than where we are currently working, please let us know of your interest. There may be an opportunity for contracting with you, and we would like to discuss this possibility with you


 

WHY YOU NEED A MENTAL HEALTH AND
BEHAVIOR MEDICINE SERVICES PARTNER


Many caregivers have always believed that the elderly have special mental health requirements. New evidence confirms those beliefs, and new regulations have made the issues more urgent.
  • 40% of nursing home residents exhibit symptoms of depression.
  • Among the 2/3’s of nursing home residents with a mental disorder, fewer than 5% receive treatment.
  • 40% of dementia patients have additional psychiatric symptoms.
  • Depression in nursing home residents is associated with increased staff care time.
  • Government regulations demand more emphasis on therapy and discourage reliance on psychotropic medication or physical restraint.
Additionally, as of January 2002, Medicare has formally recognized the value of psychological services provided to individuals in recovery or management of medical conditions. On the basis of a medical disorder only, older adults may now get behavior medicine assessment and treatment services to aid in the prevention, treatment, or management of acute or chronic medical disorders.

Referrals are made by the primary care physician, facility staff, family member, or are self-referred by the resident

The Challenge of Meeting Mental Health and Behavior Medicine Needs

Despite the need and genuine concerns among nursing home administrators, it has not been easy to provide this care for residents. Some of the practical questions have been:
  • How do you know when mental health and behavior medicine care is needed?
  • What steps must be taken to obtain resident and family agreement?
  • Can adequate reimbursement be obtained?
  • Which provider should you recommend?

A Solution at No Cost to Your Facility

Vericare was formed to make high quality mental health care a routine and convenient adjunct to your current programs. All of the services we provide are paid for by Medicare, Medicaid, private carriers or by the resident, with no cost to your facility. We furnish the administrative help you need to set up and operate a mental health and behavioral health services program.

Our Providers will become part of your treatment team, provide input for your care plans and develop a collaborative relationship with physicians and ancillary service providers.

These services are covered by most insurance payers, including:

Medicare
Medicaid/MediCal

Managed Care
Private Insurance

GETTING STARTED


If you are looking for quality, convenience and professionalism in your mental health provider, VeriCare wants to partner with you.


Putting our program into your facility is as simple as a phone call. We will contact you and help you assess your needs. If you select us as your facility’s mental and behavioral health service provider, our local staff will take care of the details.

Please let us show you how simple it can be to add our services to your facility.    
Inquire

THE Vericare PROGRAM

The services we provide are based on the needs of your residents. Our providers are all licensed and thus qualified to administer evaluations to help determine the best treatment plan for the individual resident. In addition to these initial evaluations, treatment alternatives include:
  • Individual psychotherapy for residents who can participate in and benefit from a one-on-one format, improving coping and adjustment skills, enhancing quality of life and provides insights into the resident’s special needs
  • Group therapy which offers the benefits of interaction, socialization and peer support
  • Family therapy to help family members deal with the feelings generated by placing a loved one in the care of others, such as helplessness, guilt or frustration, and to develop problem solving skills
  • Family support groups providing a forum for ongoing support and problem resolution for family members
  • Specialized programs to individualize the mental health and behavioral health
    needs of your residents. These programs provide comprehensive assessment and interventions for dementia patients, geared to their functional ability, with less reliance on medication or restraint, and assists the treatment team with residents who are not progressing in their rehabilitation
  • Residential services developed for assisted, independent living and other residential settings for the elderly
THE BENEFITS Vericare OFFERS YOUR FACILITY
Although current information and changing laws make programs like ours virtually mandatory, we believe the positive benefits are even more significant.


Your residents benefit from

  • improved mental functioning and increased sense of well-being;
  • reduced anxiety and fearfulness;
  • better adjustment to a new lifestyle and reduced functioning – medical evidence even implies that reducing depression can improve outlooks for physical illnesses and extend longevity in the case of terminal conditions.

Your staff members benefit since

  • residents will be easier to treat; untreated residents add to the burden of care;
  • problem behaviors can be reduced or better controlled, especially among those residents with advanced dementia, often with fewer restraints; they develop more effective communication approaches to enhance their caregiving;
  • employee morale increases due to increased knowledge and effectiveness in dealing with mental health issues.

Your facility benefits from

  • better positioning to comply with OBRA regulations and other licensing requirements affecting psychoactive medications and behavioral interventions;
  • gaining an important marketing advantage for attracting new residents;
  • comprehensive programs at no cost to your facility.

A COMPARISON OF MENTAL HEALTH SERVICES

When comparing mental health services, asking these questions will help you in your search. Vericare is large enough to change an industry, yet personal enough to fit into your facility. These standards reflect our attention to quality resident care, and our dedication to meeting the needs and expectations of your facility.

DOES THE MENTAL HEALTH PROVIDER:
Have a mission statement that emphasizes quality of care and customer service?
Have a management structure that emphasizes ethics and regulations?
Have long term care as 100% of their focus?
Employ LICENSED Providers and provide you with current license/malpractice information on their providers?
Offer specialized service tracks like Behavior Management and Rehabilitation as well as AIMS testing?
Offer inservice training and specialized consulting as an integral part of their program?
Conduct an extensive orientation with the provider before placement into your facility?
Provide APA-approved continuing education for their psychologist providers on a bimonthly basis and provide updates, current articles, and documentation essentials through monthly mailings?
Review cases, programs, and facility needs every quarter with your IDT?
Conduct an ongoing concurrent and retrospective quality review process utilizing a full time QM Director?
Have a Regional Psychologist/Director with long-term care experience responsible for hiring, training, evaluating, and overseeing the provider and program quality?
Employ Program Coordinators with long term care experience whose priority is to ensure a smooth, "user friendly" program?
Assure you through a check and balance system that residents are not seen without a physician order?
Provide an organized intake process that insures the resident's and/or responsible party's consent to receive treatment and to bill before any services are provided?
Document service delivery to facilitate your care planning process and revenue enhancement?
Provide an inservice on the interface between the MDS and Quality Indicators and psychological functioning?
Have separate professional corporations that can employ and place psychiatrists, nurse practitioners, and clinical nurse specialists to assist with medical consultation and work alongside the mental and behavioral health providers?

CUSTOMER SATISFACTION

How Our Customers Rate Vericare:


90%  Agree our services are helpful in
improving the resident’s quality of life.

94%  Agree that our documentation is
easily integrated into their care plans.
Customer satisfaction reflects our attention to quality resident care, and our dedication to meeting the needs and expectations of your facility.
90%  Report our providers demonstrate an understanding of OBRA and state regulations.
98%  Rate the provider as professional in demeanor.
87%  Feel our services are helpful in reducing the staff’s burden of care.
94%  Agree our providers build strong relationships with the facility’s staff.
QUALITY – Vericare improves the quality of life of residents and reduces the burden of care for staff
TEAMWORK – Vericare works closely with the IDT for integrated service delivery
COMMUNICATION – throughout the treatment planning and documentation process

UNIQUE Vericare FEATURES THAT ILLUSTRATE
OUR PROGRAMS IN ACTION:

 


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