Proximity of Behavioral Health and Primary Care Providers

Date: 

07/21/2014

Despite increasing awareness of integrated behavioral health and primary care, little is known about the distribution of integration across the United States. Currently, there is a lack of information at the state and national levels about:

  • Number and location of primary care practices with integrated behavioral health;
  • Where the potential for collaboration exists through provider proximity; and
  • Where integration cannot occur due to the absence of either a primary care or a behavioral health provider.

This article, written by Academy Principal Investigator, Benjamin Miller, PsyD, and colleagues, is featured in the recent special issue: American Psychologist. The article aims to use data from the Centers for Medicare and Medicaid Services’ National Plan and Provider Enumeration System (NPPES) Downloadable File to examine and assess where [geographic] colocation exists for primary care providers and any behavioral health provider (psychiatrists, psychologists, social workers, marriage and family therapists, and mental health counselors) and more specifically, primary care providers and psychologists. The article findings indicate, “Approximately 29% of primary care physicians are [geographically] collocated with psychologists and 43% are [geographically] collocated with any behavioral health provider.” When researchers compared the most urban areas to the most rural areas, “the percentage of primary care physicians colocated declines from 31.3 to 6.3 per 100,000 persons.”

The authors of this article suggest policy recommendations that could increase the spread of behavioral health integration. The authors go on to further explain their policy recommendations in the following fields: training, education, and workforce; payment reform; and research. 

The NPPES database only identifies if providers are [geographically] collocated. Proximity of providers does not indicate if providers are collaborating or integrated. Currently, there is not enough data to support a true count of integrated practices; however, opportunities exist to further expand this research.

Behavioral health [geographic] colocation is a prerequisite for integration of behavior health and primary care. Although this is not currently feasible everywhere, in places where [geographic] colocation exists, integration of behavioral health and primary care could quickly be enabled. The authors summarize the potential of NPPES and conclude by stating,

“The NPPES database provides an opportunity to simultaneously analyze the distributions of behavioral health and primary care clinicians and, for the first time, show where in the United States behavioral health and primary care are actually collocated.”

The article may be accessed at: http://psycnet.apa.org/journals/amp/69/4/443/