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Transformational Approach to Behavioral Health Designed by Independent Health Optimizes Quality, Access and Cost of Care for Patients

A new approach that holistically engages patients who have behavioral health concerns during a primary care office visit has proven to be an optimal process for improving quality of care and satisfaction for both patients and physicians while reducing health care costs, according to findings of the Behavioral Health Integration Program (BHIP) designed by Independent Health.


Funded by the John R. Oishei Foundation, the Peter and Elizabeth C. Tower Foundation, the Independent Health Foundation and Independent Health, this two-year pilot program involved nine family and pediatric primary care practices in Western New York. Licensed mental health counselors and social workers were trained as primary care behavioral health consultants and employed by the practices to work as part of the primary care team to engage patients with behavioral health needs, regardless of insurer.


"Behavioral health concerns are prevalent in medical care locally and throughout the U.S. Individuals with behavioral health problems must overcome several obstacles to receive the care they need in our fragmented health care system," said Judith A. Feld, MD, MPH, MMM, DFAPA, Medical Director, Provider Engagement & Behavioral Health, Independent Health. "A fundamental goal of this Behavioral Health Integration Program was to improve access to quality behavioral health assessment and management in the environment that serves as the patient's medical home - their primary care physician."


Although funding ended for this program when it concluded in September 2016, eight of the nine participating practices continue to employ their behavioral health consultants, recognizing the value they provide to primary care.


Behavioral health care has traditionally suffered from an inadequate workforce and has been traditionally delivered through specialty care settings regardless of the severity or intensity of the care needed. Many related issues can be addressed in a primary care setting; however primary care physicians are commonly unable to render this care due to a lack of integrated training and time constraints. It is estimated that more than 50 percent of primary care patients have a behavioral health concern, yet only 14 percent of those with health insurance receive treatment for mental health disorders.


During the two-year BHIP program, more than 5,000 unique patients where seen by behavioral health counselors at the nine participating practices. Other impacts of this program included:

  • More holistic management of medical conditions through behavioral support and intervention.
  • Improved recognition and timely management of mental health and substance abuse concerns within the primary care setting, avoiding long waits for specialty care.
  • Strong recognition of the value of the Behavioral Health Counselor as an integrated and invaluable member of the primary care team by both patients and physicians.
  • Decreased health care costs through improving system efficiencies, streamlining care to the appropriate healthcare setting and often avoiding unnecessary visits to emergency rooms and urgent care centers.


According to Dr. Feld, next steps include sharing lessons learned regarding the implementation and benefits of these interventions with additional primary care practices and patients throughout the community. Additional plans include expanding credentialing and training opportunities for behavioral health consultants across Western New York's health care community. This model becomes truly effective as healthcare transitions to value based care delivery. Integrating behavioral health care aligns with the mission of improving healthcare quality, efficiency and patient satisfaction by providing the right care for patients at the right time and the right place. 


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