Online Program

Person-based, holistic care: Challenges, opportunities, facilitators and funding for integrating recovery-oriented behavioral and primary care practices

Monday, November 4, 2013

Danna Mauch, PhD, US Health, Abt Associates, Cambridge, MA
John Bartlett, MD, MPH, Carter Center Mental Health Program, The Carter Center, Atlanta, GA
Vijay Ganju, PhD, World Federation for Mental Health, Cambridge, MA
Susan G. Pfefferle, PhD, Behavioral Health, Abt Associates, Cambridge, MA
Research studies indicate that individuals at risk for mental health and substance use conditions, and ripe for prevention, assessment and early intervention often appear for health services first in pediatric and adult primary care settings. The evidence points to gaps in health practitioners' knowledge and performance in addressing behavioral health conditions. However, when effective interventions are appropriately applied, reductions are achieved in medical costs and related social and economic burden for individuals and families. With expansion of eligibility for Medicaid and subsidized insurance exchange coverage, many individuals in high risk groups or with behavioral health conditions will have improved access to primary care. Given current projections on the significant shortages of primary care practitioners, increased demand will exacerbate pressures on practitioners to practice as efficiently as possible, while value based purchasing goals will add pressures to ensure results. In efforts to address prevention and treatment for behavioral health conditions, primary care practitioners face additional hurdles associated with the historical separation of behavioral health into specialty care – lack of expertise and clinical pathways to address these conditions and poorly articulated and inconsistent reimbursement structures to sustain screening, intervention and support practices. This drive for integration occurs in an era of consumer-directed care and recovery-oriented care, notions now widely accepted in the behavioral health field, but less familiar to those in the primary care sector. Effective integrated care practices support primary care practitioners to timely address prevention, treatment and recovery support for persons at risk for or with behavioral health conditions.

Learning Areas:

Chronic disease management and prevention
Provision of health care to the public

Learning Objectives:
Explain the knowledge base supporting the move to integrated care; Describe the ACA provisions driving demand and ensuring coverage for assessment and treatment of behavioral health conditions in primary care settings; Evaluate the applicability of selected evidence based and best practices, practice guidelines and protocols for efficiently and effectively delivering integrated care with a focus on the needs of persons with serious mental illness and children with serious emotional disturbances, with emphasis on a person-based, holistic orientation to delivering integrated care; and Identify strategies for addressing barriers, facilitators and opportunities to align reimbursement structures with clinical practices to promote sustainability of integrated care.

Keyword(s): Primary Care, Adult and Child Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Danna Mauch, PhD works with federal, state and local health services departments, foundations, health plans and provider organizations on planning and evaluation of benefits, service delivery and financing methods in system transformation efforts, She is a former state behavioral health director and health care executive. She is a published author of peer reviewed and government reports. Dr. Mauch received her PhD in Social Policy from the Heller School at Brandeis University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.