Integration of Behavioral Health Services with Primary Care

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Integration of Behavioral Health Services with
Primary Care

• Presented by Sharon Beaty

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I. Benefits of Integrated Care
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A. Improved Financial Outcomes

• Increase physician productivity
• a. Decreased time needed for physician with
  patient in exam room
• b. Decreased time in communication between
  providers
• 2. Additional revenue for behavioral health
  clinicians
• 3. More efficient utilization of clinic space
• 4. Better contracting capabilities

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B. Improved Patient Care

• Better communication between medical and
  behavioral clinicians
• Shorter wait times for services
• Shorter-termed therapies
• Better coordination of pharmaceutical therapies
• Improved patient compliance with medical treatment

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C. Improved Physician Satisfaction and Retention

• Reduced stress
• Improved income

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II. Misconceptions About Integrated Care What
is NOT Integration
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• Proximity or shared facility
• Common corporate umbrella and/or administrative
  services
• A convenient referral system
• Common medical record system

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III. Components of Integrated Care
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• A shared, truly integrated medical record
• Proactive integration by providers of both
  disciplines
• Instant consults and simultaneous (face-to-face)
  visits
• Consistent communication among team members

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IV. Common Barriers to Implementation
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• Lack of a shared medical/behavioral record
• Relationships between disciplines (often subtle
  and unspoken)
• Tendency of medical clinicians to expect control
• Competitive characteristics of many clinicians

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• E. Management Issues
• 1. Billing
• 2. Scheduling
• F. Dramatic differences in staffing for clinician
  types

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• G. Cultural differences between medicine and
  behavioral health clinicians
• 1. Needs
• 2. Traditions
• 3. Styles
• 4. Conventions

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V. Requirements for Successful Learning
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A. We must learn to break obstructive habits

• Physician avoidance of behavioral issues
• Forgetting that we have a collective tool kit
• Lack of sensitivity to the perspective of other
  side

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B. Behavioral health clinicians must conform to
the nature of the overall practice by

• Providing more immediate feedback (charting)
• Improving conciseness and focus of documentation
• Focusing visits
• Moving to shorter, more focused visits

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VI. A Look at Various Models and Their Success
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• Large health system in western U.S.
• Multi-site rural community health center
• Two-site rural community health center
• Maine practices

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Questions

• Thank you