Integrated Care: Uniting Physical and Behavioral Health with One Vision

Integrated care is increasingly becoming the preferred model for both physical and behavioral health. There are many reasons for this––including the rising costs of healthcare which make integrating physical and mental health more cost effective, the focus on treatment for chronic diseases, and the emphasis on a population-based approach in healthcare. In addition, new funding sources that incentivize providers to deliver value-based care have given birth to a new landscape in healthcare. Rather than discrete service delivery for physical and behavioral health, these trends are shaping a vision for the future: integrated care.

Certified Community Behavioral Health Clinics (CCBHCs), Federally Qualified Health Centers (FQHCs), Health Homes and Accountable Care Organizations (ACOs) are a few of the examples we’ve seen over the last decade that have put an emphasis on a whole-person approach to healthcare. Combining physical and behavioral health, often with crisis care, addiction treatment, nutrition and more has driven providers’ ability to share records, collaborate as a team and led to improved outcomes and reduction of healthcare spend.

Netsmart is committed to helping human services organizations expand into physical health to meet the future of integrated care. This includes primary care organizations adding or enhancing behavioral health services to adopt an integrated care model. We see this growth and expansion from providers across the healthcare continuum, for example, traditional behavioral health organizations are noticing a lack of access to primary care to address chronic conditions and comorbidities. FQHCs are also increasingly focused on expanding behavioral health services––even applying for CCBHC grants and funding. This is partly because behavioral health is a strong focus in under-resourced communities. Primary care providers working in these areas understand how important it is to have a true “view” of an individual. What are behavioral health clinicians prescribing? What support services does the individual receive? Are there co-occurring conditions? With a single view of care from both physical and behavioral health perspectives, providers can truly meet all the needs of the individuals they serve.

When we think about the key drivers of integrated care, population health at the community level plays a crucial role for improving overall health outcomes. This includes not only physical and behavioral health, but emphasis on social determinants of health (SDoH). Accessibility to housing, food, or transportation should be factored into approaches for both behavioral and physical health.

Considering all the factors included in delivering whole-person care, it's critical to look at the ability for these organizations to have access to real-time data sharing to ensure continuity and collaboration across various settings or levels of care. This includes Health Information Exchanges (HIEs), data analytics and solutions that allow for closed-loop communication. And it goes beyond interoperability. Integrated care requires solutions that can exchange, extract, and compile data to offer actionable insights across clinical, financial and operational areas of an organization. This includes performing advanced data analytics using dashboards and predictive models. All of these contribute to better outcomes, maximized reimbursement and streamlined reporting for payer and regulatory agencies.

This is important, because both behavioral health and primary care have hurdles when it comes to access and delivery. And yet both are upstream interventions which save a tremendous amount on the cost of emergency department (ED) visits and other forms of acute care. FQHCs have proven the ability for integrated care to increase preventive services and lower costs overall.

A final observation: unfortunately, many individuals avoid seeking care because behavioral health still carries a stigma. However, primary care does not. With a two-in-one integrated model, screenings with a primary care provider could identify whether a patient is at risk for a behavioral health condition and if so, ensure they receive the services they need. Many people with severe mental health disorders also have a chronic physical health condition. It takes two providers to collaborate. Integrated care allows them to do so easily and effectively, from a whole-person perspective.

If you’re a primary care clinic looking to augment with behavioral health providers, the infrastructure already exists to make that possible.

The gap between primary and behavioral health is closing every day. Care is becoming more collaborative and co-located. Integrated care is the future, and visionary healthcare organizations are joining forces to make it happen. Stay tuned for the rest of this blog series, as I dive deeper into the integrated care vision.