• Webinar to Focus on Building a Sustainable BHI Care Team

    Consider Joining Behavioral Health Integration Immersion Program Pilot

    July 13, 2022, 5:07 p.m. News Staff — The AAFP has long championed the need to incorporate mental and behavioral health services into overall medical care, as well as to ensure parity in health insurance coverage of all such care services for patients. The COVID-19 pandemic has greatly heightened the importance of achieving this integration. 

    "Bridge the gap" puzzle piece linking puzzle pieces reading "physical health" and "mental health"

    That’s why as a founding member of the Behavioral Health Integration Collaborative launched in October 2020, the Academy has thrown its support behind that group’s efforts to “help make behavioral health more accessible by providing best-in-class support to physicians working to combine mental and physical health services in their medical practices.”

    Established and supported by the AMA, the collaborative also comprises the American Academy of Child & Adolescent Psychiatry, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American College of Physicians, American Osteopathic Association, and American Psychiatric Association. Together, the organizations continue to field a vast collection of tools developed to facilitate BHI.

    BHI Benefits and Barriers

    A 2010 report from the Millbank Memorial Fund dubbed “Evolving Models of Behavioral Health Integration in Primary Care” summarized the direct and indirect benefits of implementing BHI in primary care. “Integrating mental health services into a primary care setting offers a promising, viable and efficient way of ensuring that people have access to needed mental health services,” the report noted. “Additionally, mental health care delivered in an integrated setting can help to minimize stigma and discrimination, while increasing opportunities to improve overall health outcomes.”

    Story Highlights

    Still, although integrating mental health services with primary care or overall medical care has been shown to improve global care quality and expand access to behavioral health services, widespread adoption continues to lag. According to a Rand Corp. study supported by the AMA and The Commonwealth Fund, physicians face multifactorial barriers to implementing and sustaining BHI in their practices.

    The physician organization members of the BHI Collaborative are committed to addressing those barriers but acknowledge that it can’t happen in a vacuum. A July 8 article in Health Affairs Forefront penned by leaders of the collaborative’s eight member groups called for a partnership with other key stakeholders across the health care ecosystem, particularly payers — including employers and health plans — and policymakers.

    Payers, for example, can help support widespread adoption by

    • expanding coverage and providing fair payment for stakeholders using BHI models that facilitate care management and care transitions for patients with behavioral health issues;
    • evaluating how and when to apply cost-sharing, including eliminating it when appropriate, for specified collaborative care codes, as well as integrated behavioral health services delivered in person or via telehealth;
    • assisting primary care practices in their integration efforts by offering technical support, provider training and regional resource sharing;
    • expanding provider networks and improving access to BHI by minimizing or eliminating prior authorization and other use management practices for BHI services; and
    • designing and implementing whole-person, employer-based behavioral health programs that provide immediate and direct access to culturally sensitive behavioral health resources and clinicians.

    For their part, federal and state policymakers can

    • provide long-term sustainable funding opportunities for primary care practices to support education and training on implementation of BHI services;
    • raise payment levels for BHI services among all stakeholders in federal and state coverage programs so they can be sustained by practices on an ongoing basis;
    • work with health plans and coverage programs to limit use management review practices, enforce behavioral health parity laws, and strengthen network adequacy regulations; and
    • increase federal funding — including through loan forgiveness programs, new and expanded residency, and training programs — with the aim of growing the behavioral health workforce, especially in underserved areas.

    Resources for Physicians

    Closer to home, the collaborative has put considerable effort into developing comprehensive resources and hands-on tools to assist physicians who want to incorporate behavioral health services into their medical practices. One such resource, the BHI Compendium, is a highly accessible, step-by-step guide to integrating behavioral health care, including mental health and substance use disorders, into practice.

    Updated in November 2021, the compendium presents a wide range of information, from basic BHI definitions and background to descriptions of different care models and implementation specifics such as workflow design, staff training and setting goals and metrics. It also covers various financial aspects of BHI, including billing and coding specifics and advice on how to minimize patients’ out-of-pocket costs.

    Complementing the material outlined in the compendium is a series of free webinars titled “Overcoming Obstacles: Sustaining behavioral health care in your practice.” Eighteen events covering numerous BHI-related topics have been held since the series launched in September 2020, with three more planned in the coming months. The next webinar, “Assembling the BHI care team: Roles and responsibilities,” is scheduled to air July 21 at 10 a.m. CDT.

    Sarah Coles, M.D., of Phoenix, is a featured speaker for the event. As past chair of the AAFP Commission on Health of the Public and Science and self-proclaimed Dear Pandemic website “Nerdy Girl,” Coles has been instrumental in highlighting evidence-based information on a wide range of health topics, including COVID-19.

    In the upcoming webinar, she and co-speaker Jennifer Schwartz, LMSW, will share tips on how to identify practice needs, train care team members, and assign roles and responsibilities for addressing patients’ behavioral health needs in a streamlined way. Register to learn about available tools and resources that can help identify practice and patient needs and identify qualified candidates for care team roles.

    BHI Immersion Program Opportunity

    Beginning this fall, primary care physicians will have the chance to do a deep dive into BHI by participating in a yearlong immersion program led by top industry experts. Twenty practices will be selected to receive enhanced technical assistance, via a largely virtual learning platform, on how to implement BHI effectively in their practices. The practices will choose one of two tracks in which to participate at no cost: child/adolescent patient care and adult patient care.

    The collaborative is seeking a diverse group of practices for the pilot, including those interested in implementing BHI for the first time, as well as those that previously attempted to adopt aspects of behavioral health care but did not succeed. Solo or single specialty primary care practices are eligible, as are multispecialty group practices in which at least 50% of the services provided are primary care.

    Various practice ownership models are welcome, as long as the practice leadership has made a firm commitment to BHI implementation. At the conclusion of the pilot, participants will complete a program assessment to measure and evaluate the impact of their participation in the program.

    Applications for the pilot are being accepted through Aug. 5. Additional details on the program and how to register are available online