Health insurer pays to bring primary, behavioral providers together

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Inland Empire Health Plan recently was honored by the California Department of Healthcare Services for a program focused on improving the care of members with behavioral health or substance abuse issues.

CEO Bradley Gilbert says the impetus for the initiative was simple.

“For these members, their outcomes, cost and mortality is much worse, so we needed to address the whole person via a behavioral health integrated care program,” explains Gilbert.

The project started by getting support and buy-in from local clinics and that turned out to be relatively easy. “The people who actually care for the patients want to do it better than we’ve been doing it,” he notes.

The hurdle was bringing primary care to behavioral care sites because behavioral clinics are not set up to deliver primary care and the providers had to learn how to do that.

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“We paid physician clinics to hire behavioral health workers and we paid behavioral clinics to hire physicians and health coaches,” says Gilbert. “We helped them collect and report new types of data so they could identify patients and track progress using clinical and behavioral metrics. That was work of some significance.”

Now, the primary-behavioral clinics all use a registry to collect results such as hemoglobin levels for diabetics and a nine-question screening process for patients with depression, as well as screening for hypertension. Early results of improvement in patients with hypertension found that an initial average blood pressure score of 151.9 dropped to 135.3 in three to four months.

Many of these clinics in the past have had manual paper-based processes and they had to agree to adopt electronic health records and enter the EHR world, Gilbert adds.

Over time, data in the registry will help each clinic determine the level to which patients’ overall health and behavioral outcomes are improving.

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