WELLESLEY, Mass.--(BUSINESS WIRE)--Harvard Pilgrim Health Care is working with health care providers throughout the region on an innovative, multi-faceted plan to better coordinate behavioral and medical health care for patients. As part of this initiative, Harvard Pilgrim has made quality grants to selected providers who are working to integrate these two facets of health care. Integration is of particular interest to those providers involved in Patient Centered Medical Homes (PCMH), a model that emphasizes care coordination among a patient’s specialists and primary care providers.
“We want to weave behavioral health and substance abuse detection, intervention, and follow-up into the fabric of primary care,” said Joel Rubinstein, MD, Harvard Pilgrim’s medical director for behavioral health. “This encourages providers to focus on the whole patient, giving behavioral health as much emphasis as physical health, because they are both critical to wellness.”
The quality grants have been awarded to nine physician practices in Massachusetts, New Hampshire and Maine for projects that bring a behavioral health perspective into primary or specialty care settings. Many of the recipients are making behavioral health providers an essential part of the Patient Centered Medical Home. The grants are given to a physician leader and support personnel such as a registered nurse or social worker, or behavioral health specialists such as psychologist, residents in training, behaviorist or peer support teams.
The grants are designed to bring behavioral health staff in closer, regular contact with PCMH staff, as opposed to the separation between the two disciplines that all too often exists now. Behavioral health staff participate in the core care team meetings and guide the whole team to address patient needs and barriers to care. In addition, behavioral health team members use their specialized knowledge to interact with community resources and other providers, bringing greater sensitivity to all patients regarding behavioral health diagnoses.
Several of the grant recipients are focusing on improved screening for depression, substance abuse, and other health issues, using social work staff and population health methodologies. Others are addressing the special needs of complex patients, such as those with Rhett Syndrome, or those with chronic conditions, in an integrated approach. The remainder are concentrating on training staff or using new tools for measuring the outcomes and cost savings of care coordination.
Examples of the quality grants include:
- PCMH imbedding of a behaviorist into a primary care team. The behaviorist will help identify unaddressed behavioral health needs; consult with patients, and implement behavior plans.
- Screening for depression and substance abuse at an earlier stage. The practice will initiate brief treatment or refer to another institution for more intensive treatment when necessary.
- Transitioning rural practices to a PCMH model. This program is working to integrate behavioral health services into their patients’ primary care experience. They are utilizing nurse care managers, interdisciplinary team meetings and more interaction among clinicians through such integrative techniques as coordinated treatment planning, patient hand-offs and shared patient visits.
- Implementing a behavioral health assessment tool. This practice’s clinical pediatric social worker is providing on-site assessment, consulting with physicians, and also offering short-term treatment, referrals and supportive care coordination services.
Behavioral Health Collaborative
Recognizing the operational challenges of integrating care, Harvard Pilgrim has convened a Behavioral Health Collaborative with leaders of the various grants to share information about best approaches for the melding of behavioral and medical health care. Those practices receiving quality grants are invited to quarterly meetings to discuss their experiences, resources, and ideas.
Harvard Pilgrim intends to replicate successful programs to expand upon its existing behavioral health resources for providers and members.
“We are delighted to support these efforts to make behavioral health more of a partner in primary and specialty care,“ said Cynthia Rosenberg, MD, senior medical director for Harvard Pilgrim. “Behavioral and medical care have operated in separate silos for too long, and it is our goal to benefit our patients by encouraging integration of the two. We believe that not only will patient outcomes improve, but the costs of care will be reduced for these patients. It is our goal to find initiatives that are transferrable, measurable, and sustainable for all our providers.”
About Harvard Pilgrim Health Care
Harvard Pilgrim Health Care is a not-for-profit health services company serving more than one million members in New England. Founded in 1969, the health plan has built its reputation on pragmatic innovation with a goal of lowering costs, improving care and enhancing the overall member experience. Harvard Pilgrim is known for its excellent clinical programs, customer service, health improvement strategies and innovative tools that offer consumers greater transparency and empower them to make better decisions about their health care.
Harvard Pilgrim consistently ranks among America’s highest-rated private health plans according to an annual ranking of the nation’s best health plans by the National Committee for Quality Assurance (NCQA).*
* NCQA’s Private Health Insurance Plan Rankings, 2011-15, HMO/POS/PPO. NCQA’s Health Insurance Plan Rankings 2010-11 – Private. U.S.News/NCQA America’s Best Health Insurance Plans 2005-2009 (annual). America’s Best Health Insurance Plans is a trademark of U.S.News & World Report. NCQA The State of Health Care Quality 2004.