Collaborative Care ― the “New Age” Healthcare of the millennium
The link between mind, body, and good health didn’t just start here in the United States in the 1970s with the popularity of new age philosophies and Eastern religions. The origins of the mind-body connection can be traced to Hippocrates,* the father of Western Medicine (ca. 460 B.C.Bca. 370 B.C.). For centuries, ancient healing systems have focused on the connection between mind and body and the critical role this integration plays to foster good health. That said, with today’s healthcare technology so readily available, one could ask, what took you so long?”
Population Health, ACOs, and all that jazz
Our minds and emotions are intricately connected in ways that impact behavior and health. That connection is fundamental to integrated medicine. Intuitively, it’s reasonable to assume most healthcare providers understand that behavioral health has a significant impact on medical health. After all, it makes sense to treat the “whole person,” not just the condition “de jour.” However, beyond the logical, “holistic” approach to care is the reality of our changing reimbursement system to value-based payment models. So now what makes sense clinically also can make sense financially. With an emphasis on care coordination and collaborative care, providers are making inroads in the quality of care they provide and positioning themselves for increased revenue from payer incentives and risk-sharing arrangements.
A study conducted by Center for Health Care Strategies and Mathematical Policy Research found that collaborative care programs that integrate primary care providers, care managers, and psychiatric consultants to provide care and monitor patients’ progress, have been shown to be both clinically- and cost-effective for a variety of mental health conditions.
A recent study published by The Commonwealth Fund examines how two accountable care organizations (ACOs) are implementing integrated care. According to this report, individuals with mental illness require the greatest amount of care and are the costliest to treat and manage. Researchers have proposed various models that integrate behavioral health with primary care to improve a patient’s overall outcome. Emerging payment models—like ACOs—encourage more coordinated, collaborative care among various providers treating the same patient(s). Care collaboration integrates physical, behavioral, and social healthcare delivery.
This report showcases two models of behavioral health and primary care integration. One ACO, Crystal Run Healthcare, a long-time NextGen Healthcare client, is using a combination of integrated approaches to improve collaboration among providers through proximity and increased data sharing. The second ACO, Essential Health, uses an integrated model that embeds behavioral health specialists within primary care teams and enables frequent communication and close collaboration in patient care.
The 360 degree patient view
Another NextGen Healthcare client, Behavioral Health Information Network of Arizona (BHINAZ), uses a behavioral health HIE to transmit “consented” behavioral health patient data to a repository where it is filtered. The goal is to make that patient data available to share with their extended team of providers or care givers. This enables providers to make more accurate medical decisions during the patient encounter knowing the patient’s current regime of psychotropic medications. Likewise, behavioral health providers may make more accurate decisions based on the current physical healthcare plans and medications from the patient’s primary care provider (PCP).
Just another way of saying “it takes a village”
When collaborative care teams have access to patient data anywhere/anytime, they are better able to proactively engage patients and deliver coordinated care. The result: Better outcomes for patients and providers.
Creating Connections: An Early Look at the Integration of Behavioral Health and Primary Care in Accountable Care Organizations
There Hippocrates (ca. 460 B.C.Bca. 370 B.C.) and his followers combined naturalistic craft knowledge with ancient science and philosophy to produce the first systematic explanations of the behavior of the human body in health and illness.