#11 View From Medicaid: Emerging Adults w Mental Illness
Newsletter subscribers: Apologies. My Mailchimp feed broke down, and I didn’t notice until yesterday. You’ve missed 10 episodes!! I will repost an episode every other day until we’re caught up. I’m so sorry! Dr Herndon, former Medicaid CMO: challenges faced to improve mental health care for emerging adults. Better support systems for their transition to independence Subscribers About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once. I’m the Rosetta Stone of Healthcare. We will listen and learn about what it takes to adjust to life’s realities in the awesome circus of healthcare. Let’s make some sense of all this. We respect Listeners, Watchers, and Readers . Show Notes at the end. Watch on YouTube Read Newsletter The same content as the podcast, but not a verbatim transcript. Could be a book chapter with images. download the printable transcript here Contents Proem.. 2 Podcast intro. 3 Meet Dr. Mike Herndon. 3 Health is Fragile. 3 Mental Illness in family practice. 3 Readiness to manage mental illness in practice. 4 State Medicaid Director 5 Levers of power 6 Aligning incentives 6 Minor success, at best 7 A word from our sponsor, Abridge. 8 Call to action. 8 Family Advocacy. 9 Not easy being an emerging adult 10 Reflection. 11 Podcast Outro. 11 Episode Proem According to the Commonwealth Fund, in 2016, spending in the US on behavioral healthcare was almost $160 billion, with 58 percent of all behavioral health spending being paid for by Medicare and Medicaid. According to SAMHSA , The Substance Abuse and Mental Health Services Administration, Medicaid is the largest payer in the United States for behavioral health services. Medicaid accounted for 26 percent of all behavioral health spending in 2009. Behavioral health is a term for mental health and substance use disorder conditions to differentiate from physical health. As a clinician, I seldom met a person with chronic physical health issues who didn’t also have behavioral health issues. I don’t know how meaningful statistics are, except to say a lot of people have behavioral health diagnoses in their records. It costs them, their families, and communities a fortune, and government health insurance pays a significant proportion of those direct costs. Podcast intro Welcome to Health Hats, the Podcast. I’m Danny van Leeuwen, a two-legged cisgender old white man of privilege who knows a little bit about a lot of healthcare and a lot about very little. We will listen and learn about what it takes to adjust to life’s realities in the awesome circus of healthcare. Let’s make some sense of all of this. Meet Dr. Mike Herndon Health Hats: I invited my friend and colleague, Dr. Mike Herndon , recently retired Chief Medical Officer for the Oklahoma Healthcare Authority , Medicaid, to chat with us about Emerging Adults with Mental Illness. Mike, thank you so much for joining me. Mike Herndon: You bet, Danny. Happy to be here. Health Hats: Thank you. My friend, Dr. Mike Herndon, and I have done quite a bit together over the years, mainly through PCORI, the Patient-Centered Outcomes Research Institute. We sat on an advisory panel together, then you were appointed to the PCORI Board of Governors, and I came on the board a few years later. You were my Board orientation buddy and helped me navigate and reduce the shock of the experience. I appreciate it. Let’s just jump right in. Mike, when did you first realize that health was fragile? Health is Fragile Mike Herndon: That’s an easy answer for me. I grew up in rural Oklahoma. In the summer between my sixth and seventh-grade years, I was 12 years old, and my mom had a pituitary tumor. That hormonal gland in the brain had gotten so large it caused terrif