What does your primary care physician private practice do when a patient needs mental health care?
Psychiatrists and nonphysician providers trained to provide mental health care are often hard to come by, with appointment slots few and far between, according to Yun L. Boylston MD, physician partner at Burlington Pediatrics/Mebane Pediatrics in Mebane, North Carolina. But integration with behavioral health specialists can help improve patients’ access to care and satisfaction.
“There aren’t enough specialists in psychological or psychiatric care to really refer all the patients you have that would benefit from this care,” Dr. Boylston said. “To improve patient experience and satisfaction, we really focus on making sure that patients identify your practice as their true medical home where they can receive whole-person care. ... Being able to offer behavioral care is such an integral part of the whole-patient experience at your practice.”
A tested model to improve care
Dr. Boylston and Virna Little, PsyD, LCSW-r, the co-founder of Concert Health in San Diego, presented their ideas on behavioral health integration (BHI) in private practice in the latest session that is part of the AMA Private Practice Simple Solutions series of free, open-access rapid-learning cycles that provide opportunities to implement actionable changes that can immediately increase efficiency in private practices.
The session is available to view on demand, as are all previous sessions in the AMA Private Practice Simple Solutions series (registration required).
The AMA established the BHI Collaborative with seven other leading physician organizations to catalyze effective and sustainable integration of behavioral and mental health care into physician practices.
The BHI model presents a series of advantages—notably, better access to behavioral health care. Dr. Boylston cited research from the Department of Health and Human Services that indicated that primary and behavioral care can be successfully integrated to improve access.
“Behavioral care integration works. This is not a new or novel concept. The tires have been kicked for quite some time,” she said.
“HHS has identified opportunities to expand access to behavioral health by integrating behavioral health into primary care settings. This will increase access to care by encouraging and reimbursing primary care providers,” Dr. Boylston added, citing HHS research.
Hiring, contracting options
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The combined resources and timely access are also likely to improve patient satisfaction and loyalty, more physician satisfaction and better staff retention. In addition, integrating behavioral health care into your private practice can improve the quality of care and outcomes and also has the potential to lower the cost of care for patients and your practice.
“There are more resources and options available now than there have been in the past,” noted Little. “You can hire a full or part-time behavioral health provider. You can share one with other practices in the community,” who can also share in the hiring activity, salary expense and overhead.
Dr. Boylston and Little recommended that primary care practices consider contracting with a private behavioral practice or clinic for collaborative care. Then, they added, private practices should then vet the candidates with references and data requests, outcomes and according to staffing criteria.
Recent changes have made the adoption of shared care plans easier and can help facilitate telehealth and remote patient access. Little also recommended that all physicians and other health professionals work together to maintain shared records to eliminate any delays or confusion in tracking patient progress.
When considering hiring, Little noted private practices should carefully analyze the likely usage and workload of the new behavioral clinicians and the financial impact on the collaborative practice. Physician private practices should also analyze payment from both commercial and government payers to understand the real financial impact.
It takes astute clinical judgment as well as a commitment to collaboration and solving challenging problems to succeed in independent settings that are often fluid, and the AMA offers the resources and support physicians need to both start and sustain success in private practice.
Learn more with the AMA about behavioral health integration in physician practices and explore the AMA Private Practice Physicians Section, which seeks to preserve the freedom, independence and integrity of private practice.
