Separate from the systemic hidden costs that influence payors, purchasers and employers, Primary Care practices have to be able to make a business case for Integrated Behavioral Health (IBH) as its own profit center.

Enhanced Screening
A typical online view of Primary Care prevalence distributions looks like the following:

The prevalence distributions vary from practice to practice and between regions of the country, with some of the more difficult settings having prevalence distributions double those shown above.  The occurrence of psychosocial issues is almost universally under-estimated in Primary Care and PCPs are often shocked to see their own patient prevalence distribution.  The advantage of using Patient Tools is that because the patients enter their information electronically, this type of population, and when trended, performance information is instantly available. 

Time Net Gain
When PCPs decide to start using the Patient Tools system, the depth of information shown above is now available without extra effort on the part of themselves or their staff.  Having this information changes how the PCP will handle their patients, resulting in a time net gain from time savings and additional time requirements.  For patients that were previously undetected, time is saved from not treating medical problems that are actually psychosocial.  For detected patients, the PCP does not have to spend the time doing in-depth interviews because the above information is automatically produced in a lab style report for each patient, that can be objectively presented, taking the PCP out of the role of assessor.  The staff does not have to spend time entering data, scoring or generating a report.  Offsetting these time savings, additional time is spent handling patients that normally would not be detected or addressed, but this is actually the desired result.

Once PCPs get a handle on the magnitude of the problem and how easy it is to detect, the issue often becomes one of effectively "opening the floodgates".  Until practices start using the system they do not really know how much of an issue this will be.  If the system is not detecting anything new, then obviously there is no additional time added.  If the system is detecting only a few percent more, picking up the few percent does not take that much more time and increases quality/reliability, which has a huge affect nationally.  Finally, if the system does detect significantly more patients, you can incrementally implement (start with one or two PCPs) and develop expanded services to handle them.

Expanded Services
While PCPs will use their time net gain to perform other billable services, the best way to justify IBH, especially when significantly more patients are being detected, is to build a profit center, expanding services around one of the IBH implementation models.  Covered under funding, Medicare has created new billing codes to support these types of services, enabling practices to detect and deliver BH in Primary Care. 

Better Management from Better Data
Using the Patient Tools system for detection has the added advantage that the patient has entered the data electronically, so it is available at any time for cumulative use.  Prevalence graphs like the one above are great to characterize the patient population for services planning.  Trending successive year data show how well IBH is working.  Additionally, the depth of the information goes well beyond a simple depression measure like the PHQ-9 which is typically used, providing the PCP with critical information, supporting collaboration with an integrated BH professional.  Finally for grant-based funding typically used in FQHCs or CHCs, the data is readily available to meet reporting requirement.

Better Business
Standardized assessments administered electronically provide consistent and complete information producing full documentation for medical legal purposes.  The depth of patient-centric information supports an expanded view of the practices performance well beyond typical claims data, positioning the practice for transparency, pay-for-performance and contract negotiations. 

Full documentation (electronic)

Patient-centric (more in-touch/less likely to get sued)

Provider monitoring (address issues before a suit develops)

Better Marketing/Transparency

Expand on Claims Data view

Better overall results from Population Management

Meet guidelines/best EBM practices

Better performance/satisfaction by providers/groups

Better quality care

Please Contact Us to learn more or discuss how Integrated Behavioral Health might work in your setting.