.

| d |

Services in Support of Promoting Health Behaviors in the Managed Care Environment
The Changing Role of Behavioral Health Promotion

Until recently, promotion of behavioral health was not viewed as part of the responsibilities of the mainstream health care system. The practice of medicine was focused on treating the ill rather than maintaining health among the well. Promotion of health behaviors in particular was viewed as something apart from "normal" medicine because it depended heavily on patient self-management and direction rather than on a physician's intervention.

Today, the managed care environment is beginning to realize benefits from preventive care and patient education. Spending small outlays to improve patient self-care is much less costly than repeated treatment to address the consequences of failing to motivate and educate patients.

In addition, as private managed care begins to accept management responsibilities for government-funded programs for the poor (e.g., Medicaid, Medicare, State mental health and substance abuse treatment), behavioral health promotion is becoming a contract responsibility. The HEDIS 3.0 measures for managed care entities include verification of behavioral health promotion activities.

Conwal's Role in Health Promotion/Prevention in Managed Care

During the past several years, Conwal Incorporated has sought a leadership role in the specific area of how to link community resources with managed care to promote healthy behaviors among enrollee populations. As a result, Conwal offers an impressive track record in researching and explaining "what works" in health promotion combined with an unequalled knowledge base in prevention activities under managed care. This knowledge base includes the following:

• Conduct and analysis of the only systematic nationwide survey to date of characteristics of preventive interventions and health promotion in HMOs.
• Development and maintenance of our on-line bibliographic resources focused on serious analysis of health promotion in the managed care environment.
• Development and conduct of mixed focus groups of managed care and health promotion expertise to elicit information on improving the marketing of community-based preventive intervention services to the managed care environment.

The Conwal staff is familiar with requirements of HEDIS and government guidelines affecting the administration of behavioral health promotion. In addition, Conwal personnel were responsible for the inclusion of prevention and post-treatment components into Contracting for Managed Substance Abuse and Mental Health Services: A Guide for Public Purchasers issued in 1998 by the Substance Abuse and Mental Health Services Administration (SAMHSA). Other current and recent clients include Physicians for Prevention, National Families in Action, the Medical Services of the Department of the Army, several of the National Institutes of Health, the State of Texas, and the State of Ohio.

An Integrated Team of Specialists

Conwal's wide range of activities in research, information dissemnation, and training related to health promotion under managed care result from the contributions of a multidisciplinary team of in-house expertise. Degrees and specializations currently represented among our staff include:

• Business (3 MBAs)
• Child Development (M.S.)
• Computer Science (M.S.)
• Contract Law (2 J.D.s)
• Counseling (2 M.S.)
• Economics (M.A.)
• Health Promotion (2 MPH)
• Information Science (MLS)
• Journalism (M.A.)
• Kinesiology (M.S.)
• Marketing (MBA)
• Nursing (RN)
• Psychology (2 Ph.Ds)
• Public Administration (2 MPAs)
• Public Policy (2 Ph.Ds)
• Social Work (M.S.W.)
• Sociology (Ph.D.)
• Statistics (Ph.D.)

An additional strength is that Conwal has maintained long-term relationships with consulting colleagues throughout the United States. Whenever possible, our research efforts at sites distant from Washington DC team Conwal's in-house expertise with contacts "on location." These individuals are recruited on the basis of their familiarity with local issues and their acceptance of Conwal's philosophy that managed care can provide a healthy environment for health promotion and prevention of behavioral disorders.

What Conwal Can Do For Managed Care Organizations (MCOs)

• Assessment of procedures, practices, and documentation to determine readiness of the organization for the Medicaid environment and unrealized potential in cost-effective preventive interventions.
• Assistance in improving behavioral health promotion practices/publicity. A consultative process designed to allow staff to "buy into" prevention and develop low-cost programs of prevention activities and linkages.
• Training clinical staff in screening and advisory techniques for behavioral health promotion.

What Conwal Can Do For Providers and Purchasers
(Including State and Local Government)

• Assessment of procedures, systems, and practices to determine readiness of the organization for the managed care environment and maximize potential contributions to enrollee self-care support and preventive services.
• Training in marketing, contracting, and strategic planning in preparation for health promotion. This includes analysis of the managed care market and a consultative process designed to allow staff to "buy into" prevention and develop low-cost programs of prevention activities and linkages.

What Conwal Can Do For MCOs, Providers, and Purchasers

• Outcome evaluation for patient education/preventive interventions, a recurring problem in managed care.
• Support for the design and conduct of conferences, workshops, focus groups, and other forums to advance health promotion in managed care.
• Surveys, research studies, literature review, cost-effectiveness modeling, utilization projections, QA assessments, and analyses of legislation, regulations, and contracts.
• Information dissemination through reports, publications, audiovisual programs, on-line databases, and expert "help line" services.

For Further Information
Contact ghill@conwal.com or call 703 448-2300. See summary in Stoil, M., and Hill, G. (1998) Journal of Public Health Management & Practice 4(1): 101-109.