Now is a great time to integrate primary care
and behavioral health not just in terms of policy but probably more importantly in terms
of the impact policy has on the actual care that patients receive.
We’re seeing collaborative care unfold at a unprecedented pace all across the country,
every geographic region that you can think of is doing something to integrate primary
care and behavioral health. From the Northwest region all the way to the
other side of the country in Florida, I’ve been amazed at the progress in just such a
short amount of time and this is a direct result of both policies as well as personal
feet on the ground incentives to do the right thing for patients.
And I think what’s very exciting is the work around acknowledging how much mental health
is essential in primary care and how much primary care is essential in mental health.
There are some very important opportunities to integrate primary care and behavioral health
right now especially with the acceleration across the country of the patient centered
medical home, the accountable care organization, and then some of the really important statewide
comprehensive primary care initiatives that are taking place in a number of states with
the intentions of expanding across the country. So when I think of primary care and when I
think of the word comprehensive I really think behavioral health, mental health, and especially
a more comprehensive view of the patient is what these policies are trying to aim for.
So a great example of a current policy in place right now is this movement towards understanding
how we can better treat what we call episodes of care or bundled care. And all that really
means is that instead of saying well this patient has heart disease and so let’s focus
intensively on this hospitalization around heart disease we actually are creating both
financial incentives, as well as quality measures that look at you know what, we know that a
good number of patients with heart disease also have potentially depression or other
behavioral health issues, how do we bring the right group of providers to come together
to deal with this? That’s true collaborative care.
A lot of people wonder why healthcare policy matters and I like to explain it this way,
healthcare policy is really our basic infrastructure. It’s our highway for how we think about the
healthcare system and it’s the backbone upon which we can build and do what I think people
like myself, who practice in a primary care setting, actually want to concentrate on.
And that’s delivering care. I would say to you that a lot of what we’re
seeing in developments in collaborative care come from people like the folks that I’ve
been privileged to work around who really get it and understand it and are just so thankful
that now we have policies in place to promote this kind of care.
We still have a lot of people in our country and that includes many providers who just
don’t understand what their role is. And so some of the research that’s going on right
now with the, with the assistance and support of agencies like AARQ are critical to helping
us show some of these providers who just don’t see a path forward that they too can practice
collaborative care and that they can still retain some of their individual autonomy,
and some of their cognitive ability in their specialties. We need to show that more than
ever now.