학술논문

Delivering On Accountable Care: Lessons From A Behavioral Health Program To Improve Access And Outcomes.
Document Type
article
Source
Health affairs (Project Hope). 35(8)
Subject
Humans
Retrospective Studies
Program Evaluation
Mental Disorders
Mental Health Services
Databases
Factual
Adult
Aged
Middle Aged
Academic Medical Centers
Emergency Service
Hospital
Program Development
Health Services Accessibility
United States
Female
Male
Accountable Care Organizations
Outcome Assessment
Health Care
Financing Health Care
Health Reform
Mental Health/Substance Abuse
Organization and Delivery of Care
Primary Care
Public Health and Health Services
Applied Economics
Health Policy & Services
Language
Abstract
Patients with behavioral health disorders often have worse health outcomes and have higher health care utilization than patients with medical diseases alone. As such, people with behavioral health conditions are important populations for accountable care organizations (ACOs) seeking to improve the efficiency of their delivery systems. However, ACOs have historically faced numerous barriers in implementing behavioral health population-based programs, including acquiring reimbursement, recruiting providers, and integrating new services. We developed an evidence-based, all-payer collaborative care program called Behavioral Health Associates (BHA), operated as part of UCLA Health, an integrated academic medical center. Building BHA required several innovations, which included using our enterprise electronic medical record for behavioral health referrals and documentation; registering BHA providers with insurance plans' mental health carve-out products; and embedding BHA providers in primary care practices throughout the UCLA Health system. Since 2012 BHA has more than tripled the number of patients receiving behavioral health services through UCLA Health. After receiving BHA treatment, patients had a 13 percent reduction in emergency department use. Our efforts can serve as a model for other ACOs seeking to integrate behavioral health care into routine practice.