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DiscussionReflections

Value-Based Financially Sustainable Behavioral Health Components in Patient-Centered Medical Homes

Roger G. Kathol, Frank deGruy and Bruce L. Rollman
The Annals of Family Medicine March 2014, 12 (2) 172-175; DOI: https://doi.org/10.1370/afm.1619
Roger G. Kathol
1Adjunct Professor of Internal Medicine and Psychiatry, University of Minnesota, Minneapolis, Minnesota
2President, Cartesian Solutions, Inc, Burnsville, Minnesota
MD
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  • For correspondence: katho001@umn.edu
Frank deGruy
3Woodward-Chisholm Chair and Professor of Family Medicine, University of Colorado School of Medicine, Denver, Colorado
MD
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Bruce L. Rollman
4Professor of Medicine, Psychiatry, and Clinical and Translational Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
MD, MPH
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Abstract

Because a high percentage of primary care patients have behavioral problems, patient-centered medical homes (PCMHs) that wish to attain true comprehensive whole-person care will find ways to integrate behavioral health services into their structure. Yet in today’s health care environment, the incorporation of behavioral services into primary care is exceptional rather than usual practice. In this article, we discuss the components considered necessary to provide sustainable, value-added integrated behavioral health care in the PCMH. These components are to: (1) combine medical and behavioral benefits into one payment pool; (2) target complex patients for priority behavioral health care; (3) use proactive onsite behavioral “teams;” (4) match behavioral professional expertise to the need for treatment escalation inherent in stepped care; (5) define, measure, and systematically pursue desired outcomes; (6) apply evidence-based behavioral treatments; and (7) use cross-disciplinary care managers in assisting the most complicated and vulnerable. By adopting these 7 components, PCHMs will augment their ability to achieve improved health in their patients at lower cost in a setting that enhances ease of access to commonly needed services.

  • integrated care
  • patient-centered medical home
  • health reform
  • primary care
  • behavioral health
  • financially sustainable
  • Received for publication June 8, 2013.
  • Revision received November 13, 2013.
  • Accepted for publication December 10, 2013.
  • © 2014 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 12 (2)
The Annals of Family Medicine: 12 (2)
Vol. 12, Issue 2
March/April 2014
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Value-Based Financially Sustainable Behavioral Health Components in Patient-Centered Medical Homes
Roger G. Kathol, Frank deGruy, Bruce L. Rollman
The Annals of Family Medicine Mar 2014, 12 (2) 172-175; DOI: 10.1370/afm.1619

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Value-Based Financially Sustainable Behavioral Health Components in Patient-Centered Medical Homes
Roger G. Kathol, Frank deGruy, Bruce L. Rollman
The Annals of Family Medicine Mar 2014, 12 (2) 172-175; DOI: 10.1370/afm.1619
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Subjects

  • Domains of illness & health:
    • Mental health
  • Other research types:
    • Health policy
    • Health services
    • Professional practice
  • Core values of primary care:
    • Coordination / integration of care

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  • integrated care
  • patient-centered medical home
  • health reform
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  • behavioral health
  • financially sustainable

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