Would it surprise you to learn that 75% of primary care patient visits have a behavioral health component? Behavioral health factors, including chronic disease management, mental health issues, substance abuse, tobacco use, stress, diet, and exercise, have a major influence on morbidity and mortality. So if primary care physicians are spending significant time dealing with behavioral health issues, and behavioral health influences the success of treating chronic disease, why are we not aligning behavioral health and primary care at a faster rate?
Why Combine Primary Care and Behavioral Health?
The healthcare system in the United States is changing rapidly, transitioning from fee-for-service to value-based models through support from the government and the largest payors. Success in this new landscape of value-based models will require the integration of behavioral health and primary care. The value-based care models position the primary care physician as the quarterbacks of care, with successful practices not only treating patients but also accelerating the necessary care to achieve clinical outcomes that patients deserve.
Providers should aggressively move forward with primary care-behavioral health partnerships for three key reasons:
1. Patients are coming to your door. Approximately 80% of patients with behavioral health disorders visit a primary care provider at least once per year.
2. Data suggests that if your patient’s mental illness improves, so does their physical health.
3. You can save the system money and potentially reap financial benefits. Under value-based care models, significant savings can be achieved with proper management of behavioral health conditions.
How to Integrate Behavioral Health and Primary Care
Several models can be used to integrate behavioral health or primary care into your practice. Behavioral health providers and primary care physicians looking to develop relationships should start by shifting the focus to the system itself and how these newly formed relationships can be beneficial for both disciplines, in addition to improving patient outcomes. All relationships must be structured to follow rules, regulations and ethical considerations. Let’s look at the opportunity from both sides.
Behavioral Health Providers
Behavioral health providers can develop a pre-screened patient pipeline by developing relationships with primary care practices. A helpful place to start is to consider how you, as the behavioral health provider, can help the primary care provider and their patients. Primary care providers often face challenges with medication management, counseling, care coordination, and referral management of behavioral health patients. Most of the time, primary care physicians and providers need prompt formal and informal consultations and access to appointments for their patients. Access to care is a major issue for primary care physicians’ patients and causes a burden for providers’ offices. As discussed earlier, lack of access negatively influences health outcomes. This is vital to all physicians and adds a financial component in the value-based model.
There are multiple ways to structure a relationship, including employment, professional services agreements, or even a simple access line for the patients and providers to call with questions or prompt appointments. The key is developing a personal relationship with the practice, listening to the practice’s goals and needs for behavioral health patients, and identifying managed care models that are being entertained or engaged.
Primary Care Providers
Primary care physicians can also build relationships with behavioral health providers through options like employment, subletting space to a provider, professional services agreements, or the setup of a referral line. The key to a successful relationship is the ability to secure appointments for patients in a timely manner with a clinician who understands the practice.
Primary care physicians and behavioral health providers do not need an employment relationship to provide quality integrated care. They do, however, need to build relationships that are deeper than just a cold referral. It is vital that all parties understand each other’s clinical practice styles and goals, and this comes from old-school relationship building. By focusing on relationships first, providers on both sides can form successful partnerships and, more importantly, achieve wins for patients.