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Strategies for Integrating Behavioral Health Distinction With PCMH

During one of the sessions at PCMH Congress 2019, Rebecca Durday, MPH, PCMH, CCE, practice advancement strategies, Healthcare Association for New York State, explained the importance of integrating behavioral health into primary care and provided strategies for a more seamless integration.

“Integrated behavioral health is whole person care,” she said.

According to some statistics she presented, there is a high incidence of behavioral health concerns, roughly 70%, among patients with chronic disease. She also noted that patients with behavioral health diagnoses have “poorer physical health outcomes and unique barriers to adhering to a care plan. Ms Durday explained that because these are common issues facing patients, integrated behavioral health helps improve health outcomes.

Integration has multiple models and levels, she explained. She said that the different levels include, integrated care, consultative role, co-location, and universal screening along with brief interventions.

Ms Durday then explained the use of the NCQA Behavioral Health Distinction as a pathway to the audience. She said that the PCMH model provides a foundation toward behavioral health integration. However, she noted, “an organization may not know where to start on the journey towards behavioral health integration.” She said that many are hesitant to commit to a defined model. But she explained that “the distinction model encourages the organization to look by criteria and find a path of integration that their organization is ready for.”

She said that the timing of Behavioral Health Distinction is also important. It can be applied at any time during PCMH recognition status, and this distinction lasts one year, or PCMH reporting date. She offered attendees some considerations for Behavioral Health Distinction timing:

  • Transforming vs sustaining PCMH recognition;
  • Bandwidth of transformation team;
  • Expense of applications’ and, Q-PASS enrollment.

Ms Durday also said that it is important to establish a multidisciplinary workgroup in an effort to streamline application efforts. Further, she said that a gap analysis of both groups should be conducted for organizational decisions on elective criteria, and a project plan that merges both programs should be created. Finally, she said that there should be aggregate data requests, prioritizing of measure selection, and establishment of processes that support both programs.

For those interested in reviewing the NCQA standards, she noted that the Behavioral Health Distinction details are in: Appendix 4: Distinction in Behavioral Health Integration. —Julie Gould

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