TY - JOUR
KW - Adult
KW - Child
KW - Child Behavior
KW - Child Health Services/economics
KW - Female
KW - Humans
KW - Male
KW - Mental Health Services/economics
KW - Office Visits/economics
KW - Pediatrics/methods
KW - Physicians, Primary Care/economics
KW - Primary Health Care/economics
KW - Time Factors
AU - Tawnya Meadows
AU - Rachel Valleley
AU - Mary Kelly Haack
AU - Ryan Thorson
AU - Joseph Evans
A1 - 
AB - OBJECTIVE: To examine pediatricians time spent, and resulting reimbursement payments for, addressing behavioral health concerns in a rural primary care pediatric practice.  METHODS: Research assistants observed 228 patient visits in a rural pediatric primary care office. The length of the visit (in minutes), content of visit, number and type of codes billed, and related insurance reimbursement amounts were recorded. Interrater reliability, scored for 22% of patient visits, was =90%.  RESULTS: Medical only visits lasted, on average, 8 minutes as compared with behavioral only visits that required nearly 20 minutes of physician time. Pediatricians billed up to 10 different billing codes for medical only visits but only billed 1 code for behavioral only visits. Consequently, pediatricians were reimbursed significantly less, per minute, for behavioral only visits as compared with those sessions addressing medical only or a combination of medical and behavior concerns.  CONCLUSION: Findings converge with previous research, demonstrating that behavioral health concerns dramatically affect the length of visit for primary care physicians. Moreover, this study is the first to document the specific impact of such concerns on pediatrician reimbursement for providing behavioral services. These results provide further support for integrating behavioral health services into pediatric primary care settings, thus allowing physicians to refer more difficult patients with behavioral issues to in-house collaborating behavioral health providers who can spend additional time necessary to address the behavioral health issue and who are licensed to receive mental health reimbursement.
BT - Clinical pediatrics
C5 - Financing & Sustainability; Healthcare Disparities
CP - 5
DO - 10.1177/0009922810390676
IS - 5
JF - Clinical pediatrics
N2 - OBJECTIVE: To examine pediatricians time spent, and resulting reimbursement payments for, addressing behavioral health concerns in a rural primary care pediatric practice.  METHODS: Research assistants observed 228 patient visits in a rural pediatric primary care office. The length of the visit (in minutes), content of visit, number and type of codes billed, and related insurance reimbursement amounts were recorded. Interrater reliability, scored for 22% of patient visits, was =90%.  RESULTS: Medical only visits lasted, on average, 8 minutes as compared with behavioral only visits that required nearly 20 minutes of physician time. Pediatricians billed up to 10 different billing codes for medical only visits but only billed 1 code for behavioral only visits. Consequently, pediatricians were reimbursed significantly less, per minute, for behavioral only visits as compared with those sessions addressing medical only or a combination of medical and behavior concerns.  CONCLUSION: Findings converge with previous research, demonstrating that behavioral health concerns dramatically affect the length of visit for primary care physicians. Moreover, this study is the first to document the specific impact of such concerns on pediatrician reimbursement for providing behavioral services. These results provide further support for integrating behavioral health services into pediatric primary care settings, thus allowing physicians to refer more difficult patients with behavioral issues to in-house collaborating behavioral health providers who can spend additional time necessary to address the behavioral health issue and who are licensed to receive mental health reimbursement.
PY - 2011
SN - 1533-2985
T1 - Physician "Costs" in Providing Behavioral Health in Primary Care
T2 - Clinical pediatrics
TI - Physician "Costs" in Providing Behavioral Health in Primary Care
U1 - Financing & Sustainability; Healthcare Disparities
U2 - 21196418
U3 - 10.1177/0009922810390676
VL - 50
VO - 1533-2985
Y1 - 2011
ER -