The talk about integrating behavioral health and primary care has become more intense in recent years and the federal government has been offering grants to organizations to begin pilots to figure out how best to make the integration work. One option is the behavioral health home – the health home model situated at a behavioral health agency.
Becoming a behavioral health home (BHH) is a real opportunity said Laurie Alexander, PhD, a behavioral health consultant, and Benjamin Druss, MD, a professor at Emory University’s Rollins School of Public Health, during a webinar held in mid-January.
The webinar was convened by the Substance Abuse and Mental Health Services Administration’s (SAMHSA) and the Health Resources and Services Administration’s (HRSA) Center for Integrated Health Solutions and focused on the operational issues behavioral health agencies (BHAs) need to think about when considering becoming a BHH.
“For years we’ve talked about how to optimize the overall health and wellness of consumers,” said Alexander. “By becoming a behavioral health home – in some form or function – that really does offer a very, very good path to addressing that critical issue.”
[See also: Integrating primary and behavioral care.]
However, she said, becoming a behavioral health home is not a simple thing. “It requires a major shift in roles, processes, culture and the care that agencies provide.”
Operational considerations, said Alexander, Druss and Joe Parks, MD, the medical director of the Missouri Department of Mental Health, include:
· Redesigning operations to support clinical care, with particular focus on chronic care.
· Putting in place tools to help patients/clients self-manage their care.
· Forming multidisciplinary practice teams. It is crucial for team members to function as a single unit whether or not they are located in the same building or at various locations, said Alexander. “This means having clear roles, a shared care plan, effective communication and really solid mechanisms for coordinating care between team members.”
· Having clinical information systems to allow for care coordination.
· Selecting a model – in-house, co-located or facilitated referral. Any of these models can result in high-quality care said Druss. Selecting one depends on what resources are available, what meets the needs of the BHA and the community and what capacity the BHA has.
Before making the leap to becoming a BHH said the presenters, BHAs need to reach out to relevant state agencies, formalize partnerships, seek out support and guidance from colleagues and experts and create a strategic plan.
But don’t even think about a strategic plan until relationship building has been done, said Parks. “ … start out focusing on building on trust and relationships between your partners – between the providers, the state agencies, the payers that hold the data, and getting data and working with it.”
“Planning in the absence of data,” he cautioned, “usually doesn’t lead you to a place you want to be at the end.”
While the focus of the webinar wasn’t how to finance becoming a BHH (a webinar on that topic is upcoming), Parks did estimate that the BHH projects in his state have saved $300 per member per month over a six- to nine-month period.