Behavioral Health Across Wyoming Andrew Philip, PhD, LP Senior - - PowerPoint PPT Presentation

Integrating Primary & Behavioral Health Across Wyoming

Andrew Philip, PhD, LP Senior Director – Clinical & Population Health

About PCDC

Primary Care Development Corporation (PCDC) is a national nonprofit organization and a community development financial institution catalyzing excellence in primary care through strategic community investment, capacity building, and policy initiatives to achieve health equity.

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Catalyzing excellence in primary care to achieve health equity

INVEST TRANSFORM ADVOCATE

We partner with health care providers to build capacity and improve services and

• utcomes

We provide capital to integrate services, modernize facilities, or expand operations We advance policy initiatives to bring resources, attention, and innovation to primary care

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Our Impact

Organizations Jobs Medical visits Dollars leveraged

strengthened created or preserved added through expansion in low-income communities

2,800 10,630 3.8M 1.1B

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The Current Healthcare System: Dis-integrated

• Mental Health, substance use, and physical health care providers

are typically:

• Located in different facilities/spaces
• Non-holistic in approach: focus only on a narrowly defined set of

problems (assessment, treatment, and outcomes)

• Lacking in communication/coordination of services for patients

with multiple needs

• Limited in interactions with other provider types
• Regulated, licensed, and credentialed by separate agencies
• Lacking in understanding of the interdependence of emotional functioning,

physical health, and substance use

• Unfamiliar with multi-disciplinary team work

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Cost of Treating Comorbid Conditions is High

• Costs for treating patients with chronic medical and

comorbid mental health/substance use disorders can be 2-3 times higher

• Additional costs incurred by people with behavioral

comorbidities estimated to be $293 billion in 2012

• Estimated $26 - $48 billion can be potentially saved

annually through effective integration of medical and behavioral services

Source: Melek, et al (2014). Economic Impact of Integrated Medical-Behavioral Healthcare Implications for Psychiatry. https://integrationacademy.ahrq.gov/resources/new-and-notables/economic-impact-integrated-medical-behavioral-healthcare-implications

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Cost of Treating Co-Morbid Conditions is High

>2x cost >2x cost

Source: Melek, et al (2014). Economic Impact of Integrated Medical-Behavioral Healthcare Implications for Psychiatry. https://integrationacademy.ahrq.gov/resources/new-and-notables/economic-impact-integrated-medical-behavioral-healthcare-implications

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What is Behavioral Health Integration?

“The care a patient experiences as a result of a team of Primary Care & Behavioral Health clinicians, working together with patients and families, using a systematic and cost-effective approach to provide patient-centered care for a defined population.”

Source: C. J. Peek & The National Integration Academy Council’s Lexicon for Behavioral Health and Primary Care Integration (2013)

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From Roots to Leaves

(or leaves to roots?)

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A Spectrum of Integration

Coordinated care (off-site)

• Level 1: Minimal collaboration
• Patients are referred to a provider at

another practice site, and providers have minimal communication

• Level 2: Basic collaboration
• Providers at separate sites periodically

communicate about shared patients

Co-located care (on-site)

• Level 3: Basic collaboration
• Providers share the same facility but

maintain separate cultures and develop separate treatment plans for patients

• Level 4: Close collaboration
• Providers share records and some system

integration

Highly integrated care

• Level 5: Close collaboration
• Providers develop and implement

collaborative treatment planning for shared patients but not for other patients

• Level 6: Full collaboration
• Providers develop and implement

collaborative treatment planning for all patients

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Source: Gerrity, M., Zoller, E., Pinson, N., Pettinari, C., & King, V. (2014). Integrating Primary Care into Behavioral Health Settings: What Works for Individuals with Serious Mental Illness. New York, NY: Milbank Memorial Fund. Adapted from: Gerrity, M., Zoller, E., Pinson, N., Pettinari, C., & King, V. (2014). Integrating Primary Care into Behavioral Health Settings: What Works for Individuals with Serious Mental Illness. New York, NY: Milbank Memorial Fund

Bi-Directional Opportunities in an Integrated System of Care

Behavioral health into physical medicine Physical medicine into behavioral health

Does direction make a difference? CCBHC? FQHC? Small Practice?

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Integrated Care in Practice

Partially adapted from: Robinson, P.J. and Reiter, J.T. (2007). Behavioral Consultation and Primary Care (pp 1-16). N.Y.: Springer Science + Business Media.

Universal screenings for common needs (depression, anxiety, substance use) and use of a registry to monitor population needs

Behavioral health & primary care providers working side-by-side, along with other disciplines (social work, nutrition, pharmacy, others)

Providers accessible for both curbside and in- exam room consults, same-day visits (15–30 minute consultation), and prevention education/ guidance Shared health records and care plans: All providers and members of the care management team have access to and document the patient’s care in a single medical record

Same day and ‘warm hand-off’ availability to reduce no-shows and ensure connection to care

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Meet our experts!

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PrimaryCareDevelopmentCorp @PrimaryCareDev

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Andrew Philip, PhD, LP

Senior Director – Clinical & Population Health Aphilip@pcdc.org @APhilipPsych (212) 437-3956 pcdc.org