While it’s hard to argue against the concept of integrated care, many behavioral health providers find the practical implementation of it to be a lot of work with uncertain returns. But no effort is too small.
“As we move toward alternative payment models and pay-for-outcomes, providers will see more incentives,” says Pamela Greenberg president and CEO of the Association for Behavioral Health and Wellness (ABHW). “That could be in the form of a bonus.”
Greenberg believes organizations can start their integration plans with small steps, such as collaborating with other similar providers to set local standards so they can work as a market toward integration. For example, making the effort to seek data-sharing permission from every patient could lead to future data exchange projects.
A newly released whitepaper from ABHW provides examples of integration initiatives that are already making impact. For example, in Maryland, seven managed care Medicaid plans are creating methods for exchanging mental health and substance-use disorder utilization data, including pharmacy data and health assessment results.
While co-location of behavioral and primary care is the ultimate milestone, developing a friendly relationship with primary care providers for referrals could be the initial stepping stone toward that model.
“No efforts are too small,” Greenberg says. “Work with insurers as well, and try to get plans interested as integrated care partners. Payers have the data and can be helpful.”
She also says providers must be open to unique integration models and payment models as they emerge.
Current approaches to integration occur not just among providers and payers, but also at the community and family level as well. Behavioral providers have a proven advantage in connecting all those pieces together for improved care.
Increasingly, the larger healthcare system is also recognizing that at the individual patient level, everyday behaviors have direct impact on health status overall. And behavioral providers are in a pivotal position to help foster improved behaviors through patient activation and health literacy—that is, the ability for patients to understand and act on their self-care plans. Greenberg says motivational interviewing and other patient-activation tools can help providers determine patients' readiness for change.