Primary care delivery has long centered around patient physicality, but value-based care is changing that

Primary care physicians, though, are increasingly recognizing the direct influence mental health has on patient well-being and the success of any care regimen. That understanding has largely changed the mindset and approach to practicing value-based primary care.

No longer are many doctors simply recommending additional treatment or making referrals and banking on patients to follow through on their own. Value-based practices are hiring or partnering with behavioral health specialists and stationing them at primary care centers where physicians with patients in need can quickly and easily connect with qualified help.

Literally, when I’m in a room talking to a patient who’s having an obvious problem, I click a few buttons (on a digital note-taker) and say ‘warm handoff’ and when I walk out, the onsite provider is standing right there at the door.
- Micheal Rolfsen, Medical Director for Quality at Baton Rouge Clinic in Louisiana

Because of PCPs’ focus on whole-person care, Humana MA individual members treated by value-based doctors see behavioral health specialists much more frequently than members with non-value-based providers. Some 58% of the 2.1 million behavioral health Humana MA claims in 2021 had a value-based link.

Helping drive those numbers are the inclusion of behavioral health in quality metrics and calls for earlier detection that have placed added emphasis on frontline primary care physicians to identify potential problems.

Over time, PCPs more frequently see physical and mental health as intertwined, leading to potentially greater issues around non-adherence, non-compliance and comorbidities affected by one’s emotional state. Value-based physicians financially accountable for patient well-being realize that taking care of patients and driving better outcomes requires addressing behavioral health issues.

UC Health Coordinated Care Colorado features behavioral health practitioners in about 75% of its primary care clinics. Those specialists conduct consults both in person and virtually to reach more people.

“More than anything, the move has made behavioral health more accessible,” says Dr. Amy Scanlan, UC Health’s Medical Director.

Having specialists physically in the practice goes a long way in building rapport and relationships with those they serve. They know the physicians. They know the patients as well.

“It’s much easier for them to come to the primary care office where they have been getting care,” Scanlan says.

Even with on-site assistance, demand for help among MA members continues to outpace specialist availability. Rolfsen figures he makes about 30 behavioral health referrals a month, and that the practices with 35 physicians makes upwards of 1,000 a month collectively.

Rolfsen tries to address and treat cases he feels he can– anxiety and depression, for instance, because he knows patients will struggle to get an appointment elsewhere within a reasonable timeframe.

“The world is changing, causing people to have more angst,” he says. “I worry that we don’t have the staff we need to serve the needs of the population.”

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