Gap Analysis
Gap Analysis Overview
Most Medicaid systems in the United States have three major areas of system capacity gaps related to individuals with behavioral health disorders:
The following material provides guidance on how to study what gaps might exist in the Arizona RBHA regions.
Behavioral Health Gap Analysis
In 2014, the consultants who have developed this Toolkit prepared a Community-Based Mental Health and Substance Use Disorder Services Gap Analysis for the Washington State Legislature. This analysis studied five questions for each of the ten Regional Service Areas in Washington State, which are the equivalent of the RBHA regions.
The methodology and data used for this work is very relevant to Arizona, especially the prevalence data, which came from a rigorous study completed by the Research and Data Analysis Division of the Washington State Department of Social and Health Services.
A Behavioral Health Gap Analysis Excel Template that has been customized for Arizona can be downloaded at the following link: [www.weblink-here.com]
A detailed Washington State Gap Analysis Data Book that contains a rich set of information to assist regions with their own gap analysis can be downloaded at the following link: [www.weblink-here.com]
Primary Care Gap Analysis
The United States is suffering from a shortage of primary care providers that is more extreme than other developed countries. The shortage is worse for individuals in the safety net, which we define as those who are covered by Medicaid or are uninsured. It is even worse for individuals in the safety net with behavioral health disorders.
Addressing these problems requires concerted and long term efforts by the federal government, the State of Arizona, and the RBHAs and begins with completion of a Primary Care Capacity Gap Analysis for persons with behavioral health disorders.
A Primary Care Capacity Gap Analysis Excel Template can be downloaded at the following link: [www.weblink-here.com]
The gap analysis template has a set of built-in assumptions about the importance of providing longer visits and more “touches” with individuals with behavioral health disorders because of the high prevalence of complex comorbid conditions and frequent cognitive impairments that require additional time for education and self-management support.
System stakeholders can complete the gap analysis for their region or community by completing the step by step process described in the template. The template supports projecting service gaps for different care models that range from a primary care clinic that is staffed by only primary care physicians to a team-based clinic with one or more types of physician extenders.
In addition to determining the primary care capacity gap in a region or community, the template can be used to estimate how the gap can be closed by adding primary care providers, building out primary care teams, or a combination of the two strategies.
Most Medicaid systems in the United States have three major areas of system capacity gaps related to individuals with behavioral health disorders:
- Behavioral Health Gap: There are often significant gaps between those in need of mental health and substance use disorders and those engaged in treatment. Identifying any existing gaps in a RBHA is the first step in designing a strategy to close those gaps in order to address the high total healthcare expenditures for this population.
- Primary Care Gap: There are often significant shortages in primary care capacity for individual with behavioral health disorders, especially when the analysis includes factoring in the importance of providing longer visits and more “touches” with individuals with behavioral health disorders because of the high prevalence of complex comorbid conditions and frequent cognitive impairments that require additional time for education and self-management support.
- Integrated Primary Care/Behavioral Health Treatment Setting Gaps: It is also critical to identify the number of primary care and behavioral health settings that are not yet providing integrated care in order to develop a multi-year strategy to ensure that all individuals with behavioral health disorders are served in one of the integrated settings described in the Service Delivery Redesign Section of this Toolkit.
The following material provides guidance on how to study what gaps might exist in the Arizona RBHA regions.
Behavioral Health Gap Analysis
In 2014, the consultants who have developed this Toolkit prepared a Community-Based Mental Health and Substance Use Disorder Services Gap Analysis for the Washington State Legislature. This analysis studied five questions for each of the ten Regional Service Areas in Washington State, which are the equivalent of the RBHA regions.
- Safety Net Population: How many Washingtonians are now in the safety net in each region?
- Mental Health Need: What proportion of the population in each region has an identified mental health or substance use disorder need that would benefit from treatment?
- Mental Health Treatment: How many individuals in the safety net in each region received ambulatory mental health or substance use disorder treatment in 2014?
- Treatment Gap: What gaps exist between those in need and those receiving treatment in each region?
- Gap Cost: What will it cost to close any service gaps in each region and what state and local resources are needed?
The methodology and data used for this work is very relevant to Arizona, especially the prevalence data, which came from a rigorous study completed by the Research and Data Analysis Division of the Washington State Department of Social and Health Services.
A Behavioral Health Gap Analysis Excel Template that has been customized for Arizona can be downloaded at the following link: [www.weblink-here.com]
A detailed Washington State Gap Analysis Data Book that contains a rich set of information to assist regions with their own gap analysis can be downloaded at the following link: [www.weblink-here.com]
Primary Care Gap Analysis
The United States is suffering from a shortage of primary care providers that is more extreme than other developed countries. The shortage is worse for individuals in the safety net, which we define as those who are covered by Medicaid or are uninsured. It is even worse for individuals in the safety net with behavioral health disorders.
Addressing these problems requires concerted and long term efforts by the federal government, the State of Arizona, and the RBHAs and begins with completion of a Primary Care Capacity Gap Analysis for persons with behavioral health disorders.
A Primary Care Capacity Gap Analysis Excel Template can be downloaded at the following link: [www.weblink-here.com]
The gap analysis template has a set of built-in assumptions about the importance of providing longer visits and more “touches” with individuals with behavioral health disorders because of the high prevalence of complex comorbid conditions and frequent cognitive impairments that require additional time for education and self-management support.
System stakeholders can complete the gap analysis for their region or community by completing the step by step process described in the template. The template supports projecting service gaps for different care models that range from a primary care clinic that is staffed by only primary care physicians to a team-based clinic with one or more types of physician extenders.
In addition to determining the primary care capacity gap in a region or community, the template can be used to estimate how the gap can be closed by adding primary care providers, building out primary care teams, or a combination of the two strategies.
