As described by the Institute of Medicine (IOM), a learning health care system is “designed to generate and apply the best evidence for the collaborative healthcare choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and to ensure innovation, quality, safety, and value in health care.”
When health care is not well integrated and coordinated across systems, too many patients fall through the cracks, leading to missed opportunities for prevention or early intervention. The fallout results in ineffective referrals, incomplete treatment, high rates of hospital and emergency department readmissions, and individual tragedies that could have been prevented. Effective coordination between emergency departments and primary care providers can help to prevent these tragedies.
The Purpose and design of Trijectory Corp's Healthcare Access Point is to meet these challenges head-on and provide an effective integrated approach to community based healthcare for individuals with a history of social adjustment issues. We meet the needs of high-risk clients with cost-effective community based solutions to benefit the healthcare industry and the consumers who benefit from healthcare services.
Our Goal is Win-Win.
We learn as we go.
We adapt to change.
Anthony Davis, Director
Helping Others Help Each Other
The question is.. Who Helps A Person Manage Their Life When The Offices Close For The Day?
Our Answer Is.. Each Other
Interventions that prevent substance use disorders can yield an even greater economic return than the services that treat them. At Trijectory we believe our Peer Support Groups, our Cognitive Based Therapy (CBT) programs, our 12 Step Training Academy, our CBT Relapse Prevention groups, our Motivational Interviewing Therapeutic Groups, and our Therapeutic Community Structured Living Models, WILL YIELD GREATER ECONOMIC RETURN THAN TREATMENT SERVICES on a long-term basis.
The Washington State Institute for Public Policy has used a standardized model to estimate the cost-benefit of diverse prevention, early intervention, and treatment programs. Benefit-per-dollar invested ratios for evidence-based interventions (EBIs) include $27.48 for every dollar invested in brief intervention in primary care; $36.71 for brief intervention in a medical hospital; $9.07 for brief intervention in an emergency department; $136.41 for cognitive behavior coping skills therapy; $33.71 for contingency management for substance use; $41.10 for motivational interviewing to enhance treatment engagement; $14.79 for brief marijuana dependence counseling; and $34.90 for brief cognitive behavioral intervention for amphetamine users.
Although some of the 30 interventions studied had smaller benefit-to-cost ratios than others (e.g., $2.18 for methadone maintenance treatment and $1.30 for buprenorphine/buprenorphine-naloxone treatment), all had benefits greater than their costs.
Trijectory encourages and advocates for funding community prevention programs that encourages public-private partnerships and community collaboration to improve health outcomes.
With scarce resources and many social programs competing for limited funding, cost-effectiveness is a critical aspect of substance use-related services. Over the past 20 years, several comprehensive literature reviews have examined the economics of substance use disorder treatment.
Although the United States spends roughly $35 billion across public and private payors to treat substance use disorders, the social and economic costs associated with these disorders are many times higher: Annual costs of substance misuse and substance use disorders in the United States are estimated at more than $400 billion.
Thus, treating substance use disorders has the potential for positive net economic benefits, not just in regard to treatment services but also general health care. For example, on average individuals with chronic medical conditions incur health care costs two to three times higher when they have a comorbid substance use disorder compared with individuals without this comorbidity.
The net benefits of integrated treatment include improved health care outcomes and reduced health care costs, as well as reduced crime, improved child welfare, and greater employment productivity. Major individual and societal savings also stem from fewer interpersonal conflicts, greater workplace productivity, reduced infectious disease transmission, and fewer drug-related accidents, including overdoses and deaths.
AFFORDABLE CARE ACT
"General health and behavioral health issues with criminal justice-involved individuals intersect. Using the ACA to do a better job of delivering health care and behavioral health care services to this population not only improves the health of our communities, but makes them safer"
Research shows that there are a disproportionate number of justice involved individuals suffering from chronic illness and/ or mental health and substance abuse disorders. We also know that a majority of the justice-involved individuals are young adults and unemployed or earn an income that is well below the federal poverty line leaving them without the ability to obtain health care.
Because of the many health care expansion possibilities for this population we are witnessing an unprecedented opportunity to help connect the justice population to healthcare coverage and the associated healthcare services.
By working together to build a visual portrait of how individuals progress through the criminal justice system, health and justice stakeholders gain better understanding of their respective policies and practices.
Bringing together stakeholders from criminal justice, health care, and behavioral health care systems for dialogue around these issues builds increased understanding and collaboration across systems.
CHRONIC HEALTH PROBLEMS
A large number of individuals in the criminal justice system struggle with chronic health problems and mental health and substance abuse disorders.
State and local criminal justice systems are poised to change the way they do business. With the advent of the Patient Protection and Affordable Care Act (ACA), it is now possible for millions of low-income individuals in the criminal justice system to obtain insurance coverage for their physical and behavioral health care needs. This far-reaching system change will affect every decision point of the criminal justice system, from pretrial to reentry, and every partner, from correctional health to behavioral health.
Lack of treatment can be a factor in increased recidivism. For example, a 2006 report found that among state prisoners who were dependent on drugs or alcohol, 53 percent had at least three prior sentences to probation or incarceration, compared to 32 percent of other inmates. Proper treatment—especially for behavioral health issues—can significantly reduce further criminal involvement and related costs. Yet most justice-involved individuals have been unable to access treatment.