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The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
598 Results
461
Specialty care medical homes for people with severe, persistent mental disorders
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: The patient-centered medical home concept is central to discussions about the reform of the health care delivery system. Most descriptions of the concept assume that a primary care practice would serve as the hub of the medical home. However, for people with severe and persistent mental disorders, specialty health care settings serve as the principal point of contact with the health care system. For them, a patient-centered medical home in a specialty setting would be the most expedient way to address their urgent health care needs. Among other issues, implementing this idea would mean reimbursement strategies to support the integration and coordination of primary care in specialty settings.
Topic(s):
Financing & Sustainability
See topic collection
, Medical Home
See topic collection
, Healthcare Policy
See topic collection
Reference Links: 
View the DOI record for Specialty care medical homes for people with severe, persistent mental disorders
View DOI Record
View the PubMed citation for Specialty care medical homes for people with severe, persistent mental disorders462
Specialty Physician Designation in Referrals from a Vertically Integrated PCMH
Type: Journal Article
Year: 2019
Publication Place: United States
Abstract: Introduction: Primary care referrals to specialty physicians once relied upon the medical skill of the specialist, the quality of past communication, and previous consultative experiences. As health systems vertically integrate, patterns of specialty physician referral designation are not known. Methods: This cross-sectional study from a patient-centered medical home (PCMH) evaluated the proportion of referrals with named specialists. All outpatient specialty referrals from the PCMH between July and December of 2014 were eligible for inclusion, and 410 patients were randomly selected for chart review. The outcome of interest was specialty physician designation. Other variables of interest included PCMH provider experience, the reason for referral, and time to specialty visit. Univariate analysis was performed with Fisher exact tests. Results: Of 410 specialty referrals, 43.7% were made to medical specialties, 41.7% to surgical specialties, and 14.6% to ancillary specialties. Resident physicians placed 224 referrals (54.6%), faculty physicians ordered 155 (37.8%), and advanced practice providers ordered 31 (7.6%). Only 11.2% of the specialty referral orders designated a specific physician. No differences appeared in the reason for referral, the referral destination, the proportion of visits scheduled and attended, or the time to schedule between those referrals with and without specialty physician designation. Faculty physicians identified a specific specialist in 21.4% of referrals compared to residents doing so in 4.9% (P < .0001). Conclusion: Patient-centered medical home referrals named a specific specialty physician infrequently, suggesting a shift from the historical reliance on the individual characteristics of the specialist in the referral process.
Topic(s):
Medical Home
See topic collection
Reference Links:
View the DOI record for Specialty Physician Designation in Referrals from a Vertically Integrated PCMH
View DOI Record
View the PubMed citation for Specialty Physician Designation in Referrals from a Vertically Integrated PCMH463
Specialty Physician Designation in Referrals from a Vertically Integrated PCMH
Type: Journal Article
Year: 2019
Publication Place: United States
Abstract: Introduction: Primary care referrals to specialty physicians once relied upon the medical skill of the specialist, the quality of past communication, and previous consultative experiences. As health systems vertically integrate, patterns of specialty physician referral designation are not known. Methods: This cross-sectional study from a patient-centered medical home (PCMH) evaluated the proportion of referrals with named specialists. All outpatient specialty referrals from the PCMH between July and December of 2014 were eligible for inclusion, and 410 patients were randomly selected for chart review. The outcome of interest was specialty physician designation. Other variables of interest included PCMH provider experience, the reason for referral, and time to specialty visit. Univariate analysis was performed with Fisher exact tests. Results: Of 410 specialty referrals, 43.7% were made to medical specialties, 41.7% to surgical specialties, and 14.6% to ancillary specialties. Resident physicians placed 224 referrals (54.6%), faculty physicians ordered 155 (37.8%), and advanced practice providers ordered 31 (7.6%). Only 11.2% of the specialty referral orders designated a specific physician. No differences appeared in the reason for referral, the referral destination, the proportion of visits scheduled and attended, or the time to schedule between those referrals with and without specialty physician designation. Faculty physicians identified a specific specialist in 21.4% of referrals compared to residents doing so in 4.9% (P < .0001). Conclusion: Patient-centered medical home referrals named a specific specialty physician infrequently, suggesting a shift from the historical reliance on the individual characteristics of the specialist in the referral process.
Topic(s):
Medical Home
See topic collection
Reference Links:
View the DOI record for Specialty Physician Designation in Referrals from a Vertically Integrated PCMH
View DOI Record
View the PubMed citation for Specialty Physician Designation in Referrals from a Vertically Integrated PCMH468
Strategies for Addressing the Challenges of Patient-Centered Medical Home Implementation: Lessons from Oregon
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Medical Home
See topic collection
Reference Links:
View the DOI record for Strategies for Addressing the Challenges of Patient-Centered Medical Home Implementation: Lessons from Oregon
View DOI Record
View the PubMed citation for Strategies for Addressing the Challenges of Patient-Centered Medical Home Implementation: Lessons from Oregon469
Strengthening the Coordination of Pediatric Mental Health and Medical Care: Piloting a Collaborative Model for Freestanding Practices
Type: Journal Article
Year: 2016
Publication Place: Netherlands
Abstract: BACKGROUND: Collaborative pediatric mental health and primary care is increasingly recognized as optimal for meeting the needs of children with mental health problems. This paper describes the challenges faced by freestanding specialty mental health clinics and pediatric health practices to provide such coordinated mind-and-body treatment. It describes critical elements of a proactive approach to achieving collaborative pediatric care under real-world circumstances using the patient-centered medical home neighborhood (PCMH-N) model. OBJECTIVE: The current study evaluates the field test of the Practitioner-Informed Model to Facilitate Interdisciplinary Collaboration (PIM-FIC), a systematic approach to improving inter-professional collaboration by building relationships and enhancing communication between pediatric mental health and primary care practices. METHODS: Thirty-nine providers at two mental health and two pediatric primary care practices participated in a pilot project and completed surveys prior to and following their participation. Key informant interviews were also conducted prior to the project. RESULTS: Participating practitioners' survey and interview responses indicate that the quantity and quality of communication between pediatric mental and medical health care providers increased post-project, as did satisfaction with overall collaboration. CONCLUSIONS: Improving relationships and communication are first steps in building the infrastructure to support effective coordinated care. Project results highlight practical and easily implemented strategies that pediatric mental health and primary care practices can take to strengthen their collaboration. Findings also suggest a need for collaborative care policies and competencies for child mental health providers working in freestanding practices within the PCMH-N.
Topic(s):
Healthcare Disparities
See topic collection
, Medical Home
See topic collection
470
Structuring payment for medical homes
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: Despite widespread interest in the medical home model, there has been a lack of careful assessment of alternative methods to pay practices that serve as medical homes. This paper examines four specific payment approaches: enhanced fee-for-service payments for evaluation and management; additional codes for medical home activities within fee-for-service payments; per patient per month medical home payments to augment fee-for-service visit payments; and risk-adjusted, comprehensive per patient per month payments. Payment policies selected will affect both the adoption of the model and its longer-term evaluation. Evaluations of ongoing demonstrations should focus on payment design as well as on care--and cost.
Topic(s):
Financing & Sustainability
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for Structuring payment for medical homes
View DOI Record
View the PubMed citation for Structuring payment for medical homes471
Substance Use Disorder-Related Disparities in Patient Experiences of Primary Care
Type: Journal Article
Year: 2019
Publication Place: United States
Abstract: Purpose: To assess disparities in primary care experiences for patients with a substance use disorder (SUD) diagnosis. Methods: We assessed differences in Veterans Health Administration (VA) primary care patients' experiences using data from the 2014 outpatient VA Patient-Centered Medical Home Survey of Healthcare Experiences of Patients (SHEP; N=286,026). We obtained patient demographics and diagnoses from VA electronic medical record data. Results: Patients with an SUD diagnosis reported worse experiences for 8 of 12 SHEP measures, including access, provider communication, and information received (p<0.05). Conclusion: Targeted strategies may be needed to ensure patients with SUD have favorable primary care experiences.
Topic(s):
Medical Home
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Substance Use Disorder-Related Disparities in Patient Experiences of Primary Care
View DOI Record
View the PubMed citation for Substance Use Disorder-Related Disparities in Patient Experiences of Primary Care472
Substance Use Disorder-Related Disparities in Patient Experiences of Primary Care
Type: Journal Article
Year: 2019
Publication Place: United States
Abstract: Purpose: To assess disparities in primary care experiences for patients with a substance use disorder (SUD) diagnosis. Methods: We assessed differences in Veterans Health Administration (VA) primary care patients' experiences using data from the 2014 outpatient VA Patient-Centered Medical Home Survey of Healthcare Experiences of Patients (SHEP; N=286,026). We obtained patient demographics and diagnoses from VA electronic medical record data. Results: Patients with an SUD diagnosis reported worse experiences for 8 of 12 SHEP measures, including access, provider communication, and information received (p<0.05). Conclusion: Targeted strategies may be needed to ensure patients with SUD have favorable primary care experiences.
Topic(s):
Medical Home
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Substance Use Disorder-Related Disparities in Patient Experiences of Primary Care
View DOI Record
View the PubMed citation for Substance Use Disorder-Related Disparities in Patient Experiences of Primary Care473
Summary of the National Demonstration Project and recommendations for the patient-centered medical home
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: This article summarizes findings from the National Demonstration Project (NDP) and makes recommendations for policy makers and those implementing patient-centered medical homes (PCMHs) based on these findings and an understanding of diverse efforts to transform primary care. The NDP was launched in June 2006 as the first national test of a particular PCMH model in a diverse sample of 36 family practices, randomized to facilitated or self-directed groups. An independent evaluation team used a multimethod evaluation strategy, analyzing data from direct observation, depth interviews, e-mail streams, medical record audits, and patient and clinical staff surveys. Peer-reviewed manuscripts from the NDP provide answers to 4 key questions: (1) Can the NDP model be built? (2) What does it take to build the NDP model? (3) Does the NDP model make a difference in quality of care? and (4) Can the NDP model be widely disseminated? We find that although it is feasible to transform independent practices into the NDP conceptualization of a PCMH, this transformation requires tremendous effort and motivation, and benefits from external support. Most practices will need additional resources for this magnitude of transformation. Recommendations focus on the need for the PCMH model to continue to evolve, for delivery system reform, and for sufficient resources for implementing personal and practice development plans. In the meantime, we find that much can be done before larger health system reform.
Topic(s):
Medical Home
See topic collection
, Healthcare Policy
See topic collection
Reference Links:
View the DOI record for Summary of the National Demonstration Project and recommendations for the patient-centered medical home
View DOI Record
View the PubMed citation for Summary of the National Demonstration Project and recommendations for the patient-centered medical home476
System Redesign: The Value of a Primary Care Liaison Model to Address Unmet Social Needs among Older Primary Care Patients
Type: Journal Article
Year: 2021
Abstract:
Assessing and addressing social determinants of health can improve health outcomes of older adults. The Nebraska Geriatrics Workforce Enhancement Program implemented a primary care liaison (PCL) model of care, including training primary care staff to assess and address unmet social needs, patient counseling to identify unmet needs, and mapping referral services through cross-sectoral partnerships. A PCL worked with three patient-centered medical homes (PCMHs) that are part of a large integrative health system. A mixed-methods approach using a post-training survey and a patient tracking tool, was used to understand the reach, adoption, and implementation of the PCL model. From June 2020 to May 2021, the PCL trained 61 primary care staff to assess and address unmet social needs of older patients. A total of 327 patients, aged 65 years and older and within 3-5 days of acute-care hospital discharges, were counseled by the PCL. For patients with unmet needs, support services were arranged through community agencies: transportation (37%), in-home care (33%), food (16%), caregiver support (2%), legal (16%), and other (16%). Our preliminary results suggest that the PCL model is feasible and implementable within PCMH settings to address unmet social needs of older patients to improve their health outcomes.
Topic(s):
Education & Workforce
See topic collection
, Healthcare Disparities
See topic collection
, Medical Home
See topic collection
477
Systematic Review of the Impact of Behavioral Health Homes on Cardiometabolic Risk Factors for Adults With Serious Mental Illness
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract: OBJECTIVE: This systematic review examined the impact of health homes on cardiometabolic risk among adults with serious mental illness. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures were used to conduct the systematic review. Databases were searched for peer-reviewed articles published between 1946 and August 2018 that compared health homes with a control condition (e.g., usual care and secondary data analyses using matched samples). Participants, interventions, comparisons, outcomes, and study design criteria were used to assess study eligibility. Studies were assessed for methodological quality by using the Quality Assessment of Before and After Studies With No Control Group and the Quality Assessment of Controlled Intervention Studies. RESULTS: Eighteen studies (i.e., 11 observational studies, four quasi-experimental studies, and three randomized controlled trials) reported on 17 health homes. Most studies reported increases in receipt of screening for cardiometabolic risk factors and service use. There was a modest reduction in selected cardiometabolic risk factors among people with serious mental illness, but clinical outcomes varied widely among studies. CONCLUSIONS: Improvement in cardiometabolic risk factors varied across the studies, and the clinical significance of these reductions was not clear. Peer support and self-management training may represent strategies to improve cardiometabolic risk factors. Colocation of services may not be enough to significantly affect cardiometabolic risk factors. Health homes that include standardized screening, peer support and self-management training, and intervention components that target interdependent risk factors may have a greater impact on clinical outcomes.
Topic(s):
Healthcare Disparities
See topic collection
, Medical Home
See topic collection
478
Systematic Review of the Impact of Behavioral Health Homes on Cardiometabolic Risk Factors for Adults With Serious Mental Illness
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract: OBJECTIVE: This systematic review examined the impact of health homes on cardiometabolic risk among adults with serious mental illness. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures were used to conduct the systematic review. Databases were searched for peer-reviewed articles published between 1946 and August 2018 that compared health homes with a control condition (e.g., usual care and secondary data analyses using matched samples). Participants, interventions, comparisons, outcomes, and study design criteria were used to assess study eligibility. Studies were assessed for methodological quality by using the Quality Assessment of Before and After Studies With No Control Group and the Quality Assessment of Controlled Intervention Studies. RESULTS: Eighteen studies (i.e., 11 observational studies, four quasi-experimental studies, and three randomized controlled trials) reported on 17 health homes. Most studies reported increases in receipt of screening for cardiometabolic risk factors and service use. There was a modest reduction in selected cardiometabolic risk factors among people with serious mental illness, but clinical outcomes varied widely among studies. CONCLUSIONS: Improvement in cardiometabolic risk factors varied across the studies, and the clinical significance of these reductions was not clear. Peer support and self-management training may represent strategies to improve cardiometabolic risk factors. Colocation of services may not be enough to significantly affect cardiometabolic risk factors. Health homes that include standardized screening, peer support and self-management training, and intervention components that target interdependent risk factors may have a greater impact on clinical outcomes.
Topic(s):
Healthcare Disparities
See topic collection
, Medical Home
See topic collection