February 5, 2015 | Tags: Blog | Tags: Behavioral Health Integration , PCBH , SBIRT , Screening , CCO Metric
Chances are, if you’re involved in health care transformation in Oregon you are familiar with behavioral health integration and primary care behavioral health (PCBH) as a part of patient-centered primary care teams. You have probably heard and read that behavioral health integration is vital to health care transformation.
But why is this?
The answer is quite simple: a patient’s personal behavior and psychosocial concerns significantly impact their overall health. Therefore, primary care clinics must be equipped to address these concerns in addition to their patients’ biological health in order to successfully improve patient experience of care, improve population health, and reduce costs.
What does the PCBH model of care look like in primary care practices?
For starters, primary care teams are expanding to include behavioral health providers (BHP’s), often licensed clinical social workers or clinical psychologists, who advise primary care providers on their patients’ behavioral health needs.
Additionally, the practice of universally screening patients for mental, physical and social health concerns is adopted in primary care clinics. Patients who screen positively for certain behavioral health concerns like depression or substance misuse are then provided a warm hand-off introduction to the team’s BHP. Then the patient is scheduled a follow-up visit with the BHP.
This process is often called screening, brief intervention, and referral to treatment (SBIRT). This process can often be completed across any number of behavioral health concerns in the primary care home when a primary care behavioral health provider is part of the team.
The PCBH model aligns nicely with the Oregon Health Authority’s Patient-Centered Primary Care Home model, supporting integrated team-based care.
Clinics working towards PCPCH recognition have been able to build behavioral health integration into their transformation plans. There are also CCO incentives for adopting PCBH strategies. The Oregon Health Authority's number one priority to support health care transformation is the integration of behavioral and physical health services.
PCBH adoption is not easy, however.
Implementing a new primary care team structure, learning to work together effectively across disciplines, developing standard referral and scheduling processes, ensuring a BHP is easily accessible, and billing concerns all introduce new obstacles to the patient-centered primary care home.
These common obstacles and others motivated a grassroots group of PCBH experts across the state to form the Integrated Behavioral Health Alliance of Oregon in 2014.
This group, comprised of BHP’s, clinical directors, CCO representatives, primary care providers, insurance representatives, academic institution leaders and health care transformation champions has a goal of addressing barriers to and supporting standardized and evidenced-based PCBH implementation in practices throughout Oregon.
If you have questions for, would like support from, or desire to learn more about PCBH or the Integrated Behavioral Health Alliance of Oregon, visit the CCO Oregon website.
You can read more about PCBH in Oregon and the Integrated Behavioral Health Alliance of Oregon in the Winter 2014 issue of the Oregon Academy of Family Physicians Journal.
Access SBIRT resources, including recorded webinars, screening forms, training curriculum and others on our website>>>
Julie Oyemaja, PsyD is the co-chair of the Integrated Behavioral Health Alliance of Oregon, and a primary care psychologist with nine years of experience working in different primary care settings. She has been involved in the development of three different primary care behavioral health programs within organizations with multiple Patient-Centered Primary Care Homes (PCPCHs). She is currently overseeing the development of a large PCBH program across the eight Multnomah County Health Department Tier 3 patient-centered primary care homes. She has also served on the expert oversight panel for the Patient-Centered Primary Care Institute.