Three-year, multi-site pilot will test global payment model for integrated behavioral health care

GRAND JUNCTION, Colo., July 23, 2012 /PRNewswire-USNewswire/ -- Colorado Beacon Community partner Rocky Mountain Health Plans (RMHP) will be part of a project to re-envision the role of behavioral health in primary care. If it succeeds, the effort could transform the nation's approach to behavioral health by better integrating the delivery of behavioral and physical health care.

With funding from the Colorado Health Foundation, Rocky Mountain will participate in an innovative pilot with the Collaborative Family Healthcare Association and the University of Colorado Denver department of family medicine. Using RMHP's payment system as a laboratory, the partners will select up to six practices from Grand Junction and surrounding Western Colorado communities to test a global payment model for financially sustaining integrated behavioral health care. Practice recruitment will commence this summer, and the project should be underway by spring 2013.

The project tests a global payment model that will financially support and sustain the integration of behavioral health in primary care. Researchers aim to

• better understand the costs and other factors essential to integration; and
• test the real world application of a global payment methodology–specifically, in primary care practices that have integrated behavioral health--with the goal to inform public policy and clinical practice.

Benjamin F. Miller, PsyD, the project's principal investigator, noted that research shows that treating behavioral health and physical health separately resulted in poorer outcomes and higher costs. As concerns about such fragmentation grow, so too does the body of evidence for integrating behavioral health into the primary care setting: For those who experience both physical and behavioral health disorders, integrated care can offer better access to needed treatment and improved health outcomes (Butler, et al., 2008; Goddell, et al, 2011; Kathol, et al., 2010).

Part of this effort involves overcoming the stigma of mental illness, and placing it in the larger context of health care. "Behavioral health issues, such as depression, not only directly affect patients' physical health; they also affect it indirectly, impairing adherence with and attention to their treatment plan. People don't heal as well or as quickly," he said. "Only through integrating the mind with the body can we truly make a difference in the lives of patients."

The primary care setting is the obvious place for this to happen. More people are seen in primary care offices than in any other health care setting, and more mental health issues are dealt with in primary care than in any other context, he said. "If we truly want to improve individual health, lower health care costs and improve the health of communities, we need to integrate mental and behavioral health into primary care."

Traditionally, primary care providers have not been encouraged to consult or collaborate with mental health providers because of the way the current system is designed: It ignores the behavioral needs of medical patients and provides disincentives for consultation, collaboration and coordination among clinicians. "It is our goal to disrupt old business models in health care by showing more effective models that offer realistic, practical, on-the-ground solutions that primary care providers find valuable and rewarding to their patients," Miller said. "We expect replicable case examples from the pilot that will lead to long-term sustainable change in the industry."

Patrick Gordon, program director for the Colorado Beacon Consortium, echoed that point. "This is not an academic exercise," he said. "This will be a transformative pilot that is being built with the goal of replicating success across the country." Unlike many other projects, it's not trying to tweak the status quo, he noted. "Since it's impossible to fix the problem on a per-procedure, fee-for-service basis, we are starting with fundamental redesign of the payment system.  We will implement value-based, non-fee-for-service, payments that support the integration of behavioral and primary care, and provide better support for behavior changes that are critical to improved health outcomes."

This approach fundamentally changes the structure of how behavioral health is handled. It's not a short-term fix, Gordon said. "Starting on a small scale, building as we go and leveraging the power of partnership, we are going to turn the current model on its head."

About the Colorado Beacon Consortium

The Colorado Beacon Consortium is made up executive-level representation from four mission-driven, not-for-profit, Western Colorado-based organizations, all of which have nationally acknowledged track records of coordination to achieve superior outcomes. They are Mesa County Independent Physicians' Practice Association, Quality Health Network, Rocky Mountain Health Plans and St. Mary's Regional Medical Center. The Colorado Beacon Consortium's mission is to optimize the efficiency, quality and performance of our health care system, and integrate the delivery of care and use of clinical information to improve community health. The geographic focus of the Consortium's activities includes the Colorado counties of Mesa, Delta, Montrose, Garfield, Gunnison, Pitkin and Rio Blanco.

SOURCE Colorado Beacon Consortium