Roger G Kathol

Roger G Kathol
University of Minnesota Twin Cities | UMN · Department of Psychiatry

Doctor of Medicine

About

183
Publications
11,883
Reads
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5,244
Citations
Citations since 2016
42 Research Items
1312 Citations
2016201720182019202020212022050100150200
2016201720182019202020212022050100150200
2016201720182019202020212022050100150200
2016201720182019202020212022050100150200
Introduction
Roger G. Kathol is co-owner of Cartesian Solutions, Inc., a consulting company that integrates evidence-based medical and behavioral health models of care into general medical inpatient, outpatient, and emergency department settings associated with a smaller but connected behavioral health department. Care delivery system consultations often follow from consultations to medical health plans and government agencies desiring better outcomes and lower costs for their high-cost high-need patients.
Additional affiliations
June 1999 - August 2021
University of Minnesota Twin Cities
Position
  • Professor (Associate)
Description
  • Currently on clinical faculty at University of Minnesota after 25 years as academic faculty at University of Iowa. Most of current research relates to health service use from national and regional health plan and care delivery system (USA) datasets.
July 1975 - June 1999
University of Iowa
Position
  • Research Assistant
Education
May 1970 - May 1974

Publications

Publications (183)
Article
Objective To explore the handling of psychiatric patients in medical hospitals and emergency departments (EDs) as well as hospital characteristics associated with the availability of psychiatric services in these settings. Methods From October 1, 2017, to April 1, 2018, a telephone survey regarding the presence and nature of psychiatric services w...
Article
Purpose of study: Case management is an ideal service for patients with health complexity. However, most case management models do not integrate medical and behavioral health training and interventions, and there are little data evaluating these models in privately insured populations. The purpose of this study was to evaluate impact of an integra...
Article
Full-text available
Background Chronic diseases that drive morbidity, mortality, and health care costs are largely influenced by human behavior. Behavioral health conditions such as anxiety, depression, and substance use disorders can often be effectively managed. The majority of patients in need of behavioral health care are seen in primary care, which often has diff...
Preprint
Full-text available
Background Chronic diseases that drive morbidity, mortality, and health care costs are largely influenced by human behavior. Behavioral health conditions such as anxiety, depression, and substance use disorders can often be effectively managed. The majority of patients in need of behavioral health care are seen in primary care, which often has diff...
Article
Background Little is known about how behavioral health (BH) conditions affect health care costs of cancer patients in Japan. Objective The purpose of this study is to evaluate the magnitude of general medical claims expenditures for individuals with cancer who use or do not use BH services in Japan. Methods The study used a health insurance claim...
Article
Objectives: To evaluate the magnitude of general medical claims expenditures (ie, medical service use) for individuals who use and do not use behavioral health (BH) services in the Japanese free-access medical insurance system to determine if BH patients use substantially more health services, as has consistently been reported in the United States...
Article
Background and objectives Diverse disciplines, ranging from medical psychology to general hospital psychiatry and somatic specialties, are involved in efforts to understand psychosomatic conditions and to advocate multi-disciplinary management. Depending on the kind of problem, its acuity, severity and complexity, patients present at different sett...
Chapter
To delineate the similarities and differences between adult and pediatric value-based integrated case management organizational environments, manager selection, and manager training.
Chapter
To provide a high-level view of workplace preparation for delivery of value-based adult and pediatric integrated case management.
Chapter
To describe the three primary goals in health care and the role of value-based integrated case management in achieving them.
Chapter
To illustrate implementation of a value-based integrated case management complexity assessment using adult VP-ICM methodology for Lucinda.
Chapter
To put into context the role of cross-disciplinary health condition information gathering for use in value-based integrated case management.
Chapter
To develop comfort in talking about health behaviors, cognitive issues, and emotional problems in the context of physical disease and about physical illness in the context of behavioral health issues and disorders.
Chapter
To demonstrate how to use the value-based integrated case management Complexity Assessment Grid to develop a prioritized care plan.
Chapter
To define “health complexity” and the importance of medical and “behavioral health” information in value-based, integrated case management.
Chapter
To illustrate the effects of using value-based integrated case management complexity assessments and care plans while working with an individual employed by a large manufacturer.
Chapter
To provide an overview of the adult and pediatric value-based integrated case management-complexity assessment grids.
Chapter
To describe the use of an individual value-based integrated case manager guided “dialogue” in performing relationship-based complexity assessments.
Chapter
To provide a synopsis of the Physician’s Guide, i.e., the treating clinician and case management leadership introduction to value-based integrated case management, including key features, operational aspects, and expected outcomes.
Chapter
To depict manager activities in value-based adult and pediatric integrated case management from initiation through graduation.
Book
Thoroughly revised and updated since its initial publication in 2010, the second edition of this gold standard guide for case managers again helps readers enhance their ability to work with complex, multimorbid patients, to apply and document evidence-based assessments, and to advocate for improved quality and safe care for all patients. Much has h...
Article
Full-text available
The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence inc...
Chapter
ICM is intended to augment clinical treatment from a physician by assisting in health and life circumstances that interfere with patients’ ability to improve and stabilize their health. Treating physicians maintain a focus on clinical evaluation and treatment. Physicians working with patients having an ICM manager, however, have the advantage of qu...
Chapter
Pediatric physicians have a very direct and important role in supporting integrated case management activities. The first task is to define very explicitly what level of case management is being considered by their healthcare organization. Care coordination carried out by a non-clinical (non-RN) support staff may be effective for patients with low...
Chapter
The first chapter of the Physician’s Guide goes into great detail about patient health care assistance and support programs and its case management subcategory, which requires the skills of licensed professionals with case manager competencies that match increasing levels of assist and support program intensity. Since assistance and support program...
Chapter
There are multiple domains that act independently and in concert to influence the health of children/youth. Children/youth with multiple factors in each domain and/or in multiple domains are likely to present with increased health complexity resulting in poor health outcomes and increased cost. Addressing these issues in a holistic manner, with a f...
Chapter
Even if a small percentage of those coming into contact with ICM managers show improvement, the gains in these few can compensate for the time spent with those who do not show improvement. For instance, Elina was utilizing nearly $175,000 annually in healthcare services with no relief on the horizon. If an ICM manager, such as Heather can break the...
Chapter
PICM shares many of the essential features of adult ICM. There are sufficient differences when working with a pediatric population and their families, however, that a parallel but separate approach is needed with characteristics specifically designed for children/youth. To date, we are aware of no other case management programs, especially created...
Chapter
Physicians should now have a grasp of the types of assist and support services, a conceptual framework for the value that ICM can bring to populations of patients with health complexity, how ICM can complement clinical practice, the effects of the interactions between medical and BH conditions on clinical and financial outcomes, and the foundationa...
Chapter
The practice of medicine is much more complicated than in the day of the “old fashioned” house call. Providing respectful patient-centered care remains at the heart of clinician assessments and treatments. However, with the introduction of the Patient Protection and Affordable Care Act (ACA), there is now also an expectation that physicians and oth...
Chapter
ICM and PICM are specialty programs that will increasingly contribute to health improvement and cost reduction for patients with health complexity in the future. They, however, do not provide service in isolation. Rather, theirs is a synergy between (1) the clinical and non-clinical assistance and support function they perform and (2) the clinical...
Chapter
Value-added case management has a bright future as a contributor to population health management. It utilizes trained health professionals to assist and support individual patients, identified using aggregate service use data related to an accountable population, with various levels of health complexity. In successful population health management p...
Book
Improving the outcomes for patients in our changing healthcare system is not straightforward. This grounding publication on case management helps physicians better meet the unique needs of patients who present with poor health and high healthcare-related costs, i.e., health complexity. It details the many challenges and optimal practices needed to...
Article
Full-text available
Objective: The purpose of this study was to investigate the cross-cultural validity of the Japanese version of the INTERMED assessment instrument, designed to evaluate bio-psycho-social complexity of patient populations. Patient complexity is an important variable in relation to effectiveness of treatments and health-related expenses. And in the cu...
Article
The INTERMED was developed for the early identification of biological, psychological, social and health system factors considered interacting in health complexity. This is defined as the interference with the achievement of expected or desired health and service use outcomes when patients are exposed to standard care. The aim of this study was to t...
Article
Nationally, care delivery organizations are developing accountable care organizations (ACOs), but few have an appreciation of the importance of behavioral health services or knowledge about how to include them in an ACO since their funding and delivery are currently segregated from other medical services. This commentary reviews data on the impact...
Article
Full-text available
The financial and treatment challenges of complex patients must be addressed with adequate assessment and evaluation. The INTERMED complexity instrument (INTERMED) has been developed for this purpose, but to date has not been used retrospectively. The current study represents a retrospective validity investigation of INTERMED with patients with sub...
Article
Increasing awareness of mental illness's impact on medical and psychiatric health has accelerated global efforts to integrate medical and behavioural health services. As the field of integration has advanced, numerous integrated programmes have been implemented. In examining the impact of these programmes, it is important to maintain a standardized...
Chapter
This book was written so that early- and mid-career psychiatrists and psychiatrists in training can catch a glimpse of the changing health care environment and the new roles psychiatrists will play in it. While the book summarizes where we are today, the majority of its pages are devoted to forward thinking, i.e., exploring the world of psychiatry...
Book
Integrated Care in Psychiatry: Redefining the Role of Mental Health Professionals in the Medical Setting is a landmark title in the field, offering a clear, detailed, and cohesive call by leading experts for coordinated care for patients with concurrent psychiatric and medical conditions. The renowned editors and authors argue that what is slowly o...
Article
Full-text available
Because a high percentage of primary care patients have behavioral problems, patient-centered medical homes (PCMHs) that wish to attain true comprehensive whole-person care will find ways to integrate behavioral health services into their structure. Yet in today's health care environment, the incorporation of behavioral services into primary care i...
Article
The integration of behavioral health (BH) and primary care services has been the subject of considerable attention for almost a decade. Such work has been motivated by the prevalence of chronic health problems in persons with BH conditions and correspondingly high rates of early death. Service integration efforts typically included cross-referral o...
Article
The integration of behavioral health and primary care has become an increasingly important topic, with health care reform placing new emphasis on providing care that meets the spirit of the “Triple Aim”: better clinical outcomes, cost containment, and enhancing the patient experience of care.
Article
Objective: This article describes an innovative integrated approach to case management using a standardized complexity assessment grid and communication tool, which is designed to identify barriers to improvement in 4 domains: biological, psychological, social, and health system; to create and implement holistic care plans based on "anchored barri...
Article
In 2008, the Board of the European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) and the Academy of Psychosomatic Medicine (APM) Council commissioned the creation of a task force to study consensus-based summaries of core roles, scope of clinical practice, and basic competencies for psychiatrists working in the field of...
Article
An abstract is unavailable. This article is available as HTML full text and PDF.
Article
Care management-based interventions promoting integrated care by combining primary care with mental health services in a coordinated and colocated manner are increasingly popular; yet, the benefits of specific approaches are not well established. We conducted a systematic review of integrated care trials in US primary care settings to assess whethe...
Article
The 5% of patients using 50% of health resources commonly have interacting and persistent multimorbid illnesses; concurrent mental health problems; impaired social networks; and/or difficulties in accessing care through the health system. To improve outcomes in these patients, it is necessary to overcome clinical and nonclinical barriers that lead...
Article
In 2008, the Board of the European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) [corrected] and the Academy of Psychosomatic Medicine (APM) Council commissioned the creation of a task force to study consensus-based summaries of core roles, scope of clinical practice, and basic competencies for psychiatrists working in...
Article
Full-text available
The treatment of psychiatric illnesses, prevalent in the general hospital, requires broadly trained providers with expertise at the interface of psychiatry and medicine. Since each hospital operates under different economic constraints, it is difficult to establish an appropriate ratio of such providers to patients. The authors sought to determine...
Article
To assess pragmatic challenges faced when implementing, delivering, and sustaining models of integrated mental health intervention in primary care settings. Thirty percent of primary care patients with chronic medical conditions and up to 80% of those with health complexity have mental health comorbidity, yet primary care clinics rarely include ons...
Article
Full-text available
In their current configuration, traditional reactive consultation-liaison services see a small percentage of the general-hospital patients who could benefit from their care. These services are poorly reimbursed and bring limited value in terms of clinical improvement and reduction in health-service use. The authors examine models of cross-disciplin...
Article
Full-text available
To describe models of integrated care used in the United States, assess how integration of mental health services into primary care settings or primary health care into specialty outpatient settings impacts patient outcomes and describe barriers to sustainable programs, use of health information technology (IT), and reimbursement structures of inte...
Article
After sharing several case examples of health care for patients who have mental health/substance use disorders (MH/SUDs) in the current health care environment, this article describes the advantages that would occur if assessment and treatment of MH/SUDs became a clinical, administrative, and financial part of physical health with common provider n...
Article
The authors examined the factors associated with referral errors in which the presence of delirium was ostensibly not recognized by medical staff personnel. Medical records of 541 university-hospital patients consecutively referred for psychiatric consultation were scrutinized for extant delirium. The data indicated that a greater likelihood of a m...
Article
The authors investigated psychiatric consultation in two hospitals, one in the United States, the other in Japan. They examined similarities and differences, and drew inferences on possible cross-cultural values and/or temporary cultural conditions. As compared with the Japanese consultation patients, the Americans had more mood disorders, includin...
Article
Full-text available
This study evaluates patient characteristics that might predict a missed diagnosis of delirium prior to being seen by a psychiatric consultant. Study participants were assessed using quantitative standardized scales of cognitive function, delirium and physical impairment. Referring service personnel missed the diagnosis of delirium in 46% of psychi...
Article
Full-text available
The health care system in the United States, plagued by spiraling costs, unequal access, and uneven quality, can find its best chance of improving the health of the population through the improvement of behavioral health services. It is in this area that the largest potential payoff in reduction of morbidity and mortality and increased cost-effecti...
Article
The data that were reviewed in this article documented that in health systems, which manage behavioral health disorders independently from general medical disorders, the estimated 10% to 30% of patients with behavioral health service needs can expect (1) poor access or barriers to medical or mental health care; (2) when services are available, most...
Article
Several countries, such as the USA, inadvertently created a different behavioral health payment system from the rest of medicine through the introduction of diagnostic-related group exemptions for psychiatric care. This led to isolation in the administration and delivery of care for patients with mental health and substance abuse disorders from oth...
Article
To review the value provided when health care systems independently manage medical and psychiatric care. The authors draw on data from the world literature, their own experiences and reflections (one author as an international consultant in the coordination of physical and behavioural health care), and input from colleagues throughout the world who...
Article
Objective: To review the value provided when health care systems independently manage medical and psychiatric care. Method: The authors draw on data from the world literature, their own experiences and reflections (one author as an international consultant in the coordination of physical and behavioural health care), and input from colleagues throu...
Article
To quantify the magnitude of general medical and/or pharmacy claims expenditures for individuals who use behavioral health services and to assess future claims when behavioral service use persists. Retrospective cost trends and 24-month cohort analyses. A Midwest health plan. Over 250,000 health plan enrollees during 2000 and 2001. Claims expenditu...
Article
The present study examines the characteristics of post-transplant patients compared with non-transplant patients seen by consultation psychiatrists. Medical records of 541 consecutive psychiatric consultation patients at a university teaching hospital in 2001 were reviewed. Of the 541 patients who were evaluated, 67 were post-transplant patients. P...
Article
The purpose of this study was to examine the factors affecting the timing of psychiatric consultations and length of stay in the current managed care era. It also assessed the relationships between the timing of consultations and demographic/clinical characteristics. Medical records of 541 consecutive psychiatric consultation patients at a universi...