A recent study article in Annals of Internal Medicine showed that four factors impact the implementation of behavioral health integration initiatives. The researchers found four factors that influence the implementation of behavioral health integration initiatives. Here is a breakdown of each:
1. Personalized Approach to Behavioral Health Integration
According to the researchers, integration is not a one-size-fits-all approach. It is essential to understand each organization’s specific needs and circumstances and tailor strategies to meet these unique needs. The authors recommend that health care providers have a team-based care model that includes a multi-disciplinary staff and integrated care throughout all service lines, an evidence-based, individualized approach to care, and an appropriate and accessible system to inform patients of their behavioral health benefits.
2. Physician Practice Motivations for Behavioral Health Integration
The researchers found that many practice factors, such as the generally agreed upon benefits of behavioral health integration, confidence in the effectiveness of behavioral health integration, and the presence of a physician champion, were associated with the successful implementation of behavioral health integration. In addition, physician enthusiasm and perceived physician support were important factors. One study reported that integration requires a facilitator or a champion who is typically found in the practice’s leadership to be successful. The intervention should be seen as a top priority to physicians, residents, and staff.
3. Barriers Against Behavioral Health Integration
According to the researchers, the most commonly cited reasons for not adopting more integration of behavioral health care were the lack of time and training, financial incentives, and reimbursement issues. Other barriers included a lack of communication between behavioral and medical departments, a perceived lack of need, and knowledge in behavioral health integration.
4. Impact of Payment Models on Integration
Most insurers require that a patient’s behavioral health care be authorized before medical treatment. For example, if a patient is receiving inpatient treatment for a physical condition, they may need outpatient behavioral health care authorized by the insurer before receiving medical treatment. The researchers state that this can result in multiple authorizations, bureaucratic processes, and increased time between physician orders and service provision.
The authors recommend that an integrated care model be the default, with a standardized process and electronic health record (EHR) to minimize the delay between the authorization for behavioral health services and the provision of medical services. The authors suggest that a collaborative care model would be more appropriate and efficient.
On Promoting Behavioral Health Integration
Many experts suggest a more effective multi-disciplinary approach to behavioral health integration. In addition, behavioral health providers should build a plan to promote behavioral health integration by:
- Increasing physician awareness about the need for behavioral health services
- Promoting the benefits of behavioral health integration to physicians and staff
- Establishing a culture of support for behavioral health providers and staff for their contributions to the organization
- Creating a communication plan to promote behavioral and medical integration
- Providing incentives to promote behavioral health integration
- Training physicians on behavioral health integration and the unique needs of patients with co-occurring disorders
- Offering resources, such as referral services and educational programs, to better support behavioral health integration
The researchers also recommend that practice-level factors, such as leadership structure, leadership style and peer review, be considered when developing an organizational strategy for behavioral health integration.
The study’s authors conclude that it is not always necessary to create an entirely new model of care to improve the integration of behavioral health care. Smaller steps can significantly impact improving the overall health of a patient.
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