Welcome to the fifth edition of the CFHA News and Research
Column, a new series of posts that highlight recent developments in the field
of collaborative and integrated care. Check back for additional reports.
The SAMHSA-HRSA Center for Integrated Health Solutions is offering a webinar on March 28th, 2017 to help you make the most of the electronic health record (EHR) to support improved patient outcomes. Health technology experts and a behavioral health manager will show how to improve electronic health record workflows, data entry and reports for depression screening and follow-up interventions. They will also discuss practical strategies for sharing data with the team to improve benchmarking and quality.
On February 17, 2017 the Utah House passed a bill designed to deal with opioid misuse by requiring medical professionals to complete several hours of training in SBIRT which stands for Screening, Brief Intervention, and Referral to Treatment. SBIRT is designed to identify patients with problematic use of alcohol and drugs. Utah physicians would complete the training when renewing their medical license and would then receive reimbursement afterward. Before the current legislative session, Republican Representative Steve Eliason met with former directors of the National Institute on Drug Abuse and the National Institutes of Health. “I said, if there’s one thing we could do to address our opioid overdose problem, what would it be? And it’s this bill,” Eliason said.
New payment models and dedicated efforts to coordinate care are changing the delivery of health care, but more progress needs to be made, panelists said March 6, 2017 at the National Coalition on Health Care Forum on health policy. “Primary care has been overlooked for too long in discussions about health care reform,” said National Coalition on Health Care President and CEO John Rother, J.D. Benjamin Miller, Psy.D., director of the Eugene S. Farley Jr. Health Policy Center at the University of Colorado in Aurora, spoke about the need for greater integration between primary care and mental health, noting that treatment of physical and mental needs is too often artificially segregated. The forum was the first in a three-part series co-hosted by the AAFP, National Coalition on Health Care, National Association of Community Health Centers, American College of Physicians and American Osteopathic Association. The next event is a March 28 forum on primary care’s role in underserved communities.
Humana and Quartet, a technology company, are teaming up to improve access to care for New Orleans Medicare Advantage members living with anxiety, depression and addiction. Quartet technology allows primary care physicians to initiate their patients into a proven collaborative behavioral program. Resources include a highly curated group of local behavioral health providers, live psychiatry consults for providers, data driven insights through adaptive learning algorithms, and concierge support for patients. An estimated $48.3 billion could be cut from the total cost of health care in the United States each year by effectively integrating physical and mental health services, according to a 2014 study by leading actuarial firm, Milliman Inc. Quartet provides a scalable, evidence-based solution to integrate physical and mental health care that reduces costs and improves health outcomes.
Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care: The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. This article describes alternatives to the traditional fee for service (FFS) model, including modified FFS, pay for performance, bundled payments, and global payments (i.e., capitation). We suggest that global payment structures provide the best fit to enable and sustain integrated behavioral health clinicians in ways that align with the Triple Aim. Finally, we present recommendations that offer specific, actionable steps to achieve payment reform, complement PCMH, and support integration efforts through policy.
Integration of Behavioral Health for Adolescents and Young Adults in Primary Care Settings: A Systematic Review: Integration of behavioral health into primary care settings has the potential to address barriers and improve outcomes for adolescents and young adults. In this paper, we review the current research literature for behavioral health integration in the adolescent and young adult population and make recommendations for needed research to move the field forward.
Experiencing integration: a qualitative pilot study of consumer and provider experiences: Existing frameworks for integration have been heavily influenced by the provider and organizational perspectives. They are useful for conceptualizing integration from a professional perspective, but are less relevant for consumers’ experiences. Consumers of integrated primary health care may be more focused on relational aspects of care and outcomes of care.
Integrated Psychological Services for Anxiety and Depression in a Safety Net Primary Care Clinic: Despite the recognized importance of integrated behavioral health, particularly in safety net primary care, its effectiveness in real world settings has not been extensively evaluated. This article presents 2 successive studies examining the effectiveness of integrated behavioral care in a safety net setting. These results support the short- and long-term treatment effects of brief primary care behavioral interventions, further strengthening the case for integrated behavioral healthcare in safety net settings.
Outcomes of Integrated Behavioral Health with Primary Care: Integrating behavioral health and primary care is beneficial to patients and health systems. However, for integration to be widely adopted, studies demonstrating its benefits in community practices are needed. The objective of this study was to evaluate effect of integrated care, adapted to local contexts, on depression severity and patients’ experience of care. Results show that integrating behavioral health and primary care, when adapted to fit into community practices, reduced depression severity and enhanced patients’ experience of care.