The mission Commonwealth Fund is to promote a highperforming health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low income people, the uninsured, minority Americans, young children, and elderly adults.
The psychologists follow standard care pathways to identify and treat behavioral health problems that should be associated with chronic pain, sleep disorders, pediatric obesity, and adult and pediatric attention deficit hyperactivity disorder.
The hospital system separately embedded a psychologist in its neonatal intensive care unit to work with families to reduce stress and help them recognize and foster their babies’ neurological development. They will follow bestpractice protocols to treat patients’ behavioral health issues and make referrals. The initiative led to a reduction in NICU length of stay because parents were more comfortable taking their children home earlier. Just think for a moment. The behavioral health team working in Advocate’s hub will also be available to primary care physicians for consultations. Some large primary care practices will have embedded behavioral health practitioners to provide assessment, education, and treatment. Ok, and now one of the most important parts. Part of Advocate’s behavioral health integration plan includes having primary care physicians perform behavioral health screenings during office visits for all adults.
Patients deemed to be at mild risk are treated by primary care physicians with assistance from a care manager. For patients with more moderate and severe conditions, primary care practices receive support from ‘onsite’ mental health professionals, including psychiatric nurse practitioners, social workers, and psychologists, who can intervene and guide care as necessary or refer patients to more intensive inpatient and outpatient psychiatric care.
Intermountain is in expanding process its behavioral health integration efforts to engage providers in its sleep, spine, and ob gyn practices in assessing patients and providing treatment as needed.
In such settings, patients’ underlying behavioral health problems, including depression, may influence outcomes. Team members will also screen patients admitted to the hospitals medical floors, either through ‘face to face’ visits or telehealth technology, focusing on those who have had multiple admissions or readmissions as well as those with chronic conditions.
In its clinics, primary care physicians screen every patient for substance abuse and mood disorders and engage embedded behavioral health consultants in co managing patients care who screen positive for these conditions and other behavioral health challenges that emerge in the course of a visit.
Psychiatrists are also available for consults. They also see patients during all prenatal and ‘wellchild’ visits to assess psychosocial challenges, review screening results, and provide guidance and coaching to parents. The psychologists, who are often brought into the exam room, are also called upon to help when psychosocial challenges interfere with a patient’s health and treatment and/or when patients would benefit from a behavior change or better self management of chronic conditions.
it added 10 clinical psychologists to ‘communitybased’ primary care and pediatric practices, federally qualified health centers, and throughout the hospital, to help identify patients with underlying behavioral health needs and develop a treatment plan, as part of the CCO’s efforts to improve care for Medicaid beneficiaries. It found when Medicaid patients saw a behavioral health consultant to improve nonbehavioral selfmanagement health conditions, utilization of medical services fell by 28 percent over the next two years, when Cherokee analyzed medical use patterns. Although, the system also saw a 20 percent decrease in medical use services among commercially insured patients over a twoyear period. Data from a large commercial payer also showed Cherokee Health Systems patients had psychiatric lowest rates hospital admissions among all community health centers in the state.