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The Literature Collection contains over 11,000 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).
619 Results
501
Technologies in the patient-centered medical home: Examining the model from an enterprise perspective
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: Fee-for-service reimbursement has fragmented the healthcare system. Providers are paid based on the number of services rendered instead of quality, leading to the cost of care rising at a faster rate than its value. One approach to counter this is the Patient-Centered Medical Home (PCMH), a primary care model that emphasizes team-based medicine, a partnership between patients and providers, and expanded access and communication. The transition to PCMH is facilitated by innovative technologies, such as telemedicine for additional services, electronic medical records to document patients' health needs, and online portals for electronic visits and communication between patients and providers. Implementing these technologies involves tremendous investment of funds and time from practices and healthcare organizations. Although PCMH does not require such technologies, they facilitate its success, as care coordination and population management necessitated by the model are difficult to do without. This article argues that there is a paradox in PCMH and technology is at its center. Although PCMH intends to be cost effective by reducing hospital admissions and ER visits through providing better preventative services, it is actually a financial risk due to the very real upfront costs of implementing and sustaining technologies needed to carry out the intent of the PCMH model, which may not be made up immediately, if ever. This article delves into the rationale behind why payers, providers, and patients have adopted PCMH regardless of this risk and in doing so, maps out the roles that innovative technologies play in the conversion to PCMH.
Topic(s):
Financing & Sustainability
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, HIT & Telehealth
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, Healthcare Policy
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, Medical Home
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Reference Links: 
View the DOI record for Technologies in the patient-centered medical home: Examining the model from an enterprise perspective
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View the PubMed citation for Technologies in the patient-centered medical home: Examining the model from an enterprise perspective504
The Behavioral Health Laboratory: Building a stronger foundation for the patient-centered medical home
Type: Journal Article
Year: 2010
Publication Place: United States
Topic(s):
Medical Home
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Reference Links:
View the DOI record for The Behavioral Health Laboratory: Building a stronger foundation for the patient-centered medical home
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View the PubMed citation for The Behavioral Health Laboratory: Building a stronger foundation for the patient-centered medical home505
The changes involved in patient-centered medical home transformation
Type: Journal Article
Year: 2012
Publication Place: United States
Topic(s):
Medical Home
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Reference Links:
View the DOI record for The changes involved in patient-centered medical home transformation
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View the PubMed citation for The changes involved in patient-centered medical home transformation506
The Columbia-Harlem Homeless Medical Partnership: A new model for learning in the service of those in medical need
Type: Journal Article
Year: 2009
Publication Place: United States
Abstract: Though altruism and patient advocacy are promoted in medical education curricula, students are given few opportunities to develop these skills. Student-run clinics focusing on the health needs of the underserved can provide important health services to needy patients while providing students with career-influencing primary care experiences. The Columbia-Harlem Homeless Medical Partnership (CHHMP)-a project initiated by medical students to provide primary care to Northern Manhattan's homeless population-serves as a new model of service learning in medical education. Unlike many other student-run clinics, CHHMP has developed direct patient outreach, continuous care (stable "student-patient teams" and a weekly commitment for all volunteers), and regular internal data review. Chart review data presented demonstrate the project's success in providing care to the clinic's target population of homeless and unstably housed patients. Targeted outreach efforts among clients have increased rates of patient follow-up at each subsequent review period. Additionally, CHHMP has used review data to develop services concordant with identified patient needs (psychiatric care and social services). CHHMP has recruited a committed group of volunteers and continues to engender an interest in the health needs of the underserved among students. Not only does CHHMP provide a "medical home" for homeless patients, it also provides a space in which students can develop skills unaddressed in large teaching hospitals. This project, a "win-win" for patients and students, serves as a unique model for community health-based service learning in medical education.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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, Medical Home
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Reference Links:
View the DOI record for The Columbia-Harlem Homeless Medical Partnership: A new model for learning in the service of those in medical need
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View the PubMed citation for The Columbia-Harlem Homeless Medical Partnership: A new model for learning in the service of those in medical need507
The complexity, diversity, and science of primary care teams
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Financing & Sustainability
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, Medical Home
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Reference Links:
View the DOI record for The complexity, diversity, and science of primary care teams
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View the PubMed citation for The complexity, diversity, and science of primary care teams508
The development of joint principles: integrating behavioral health care into the patient-centered medical home
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
Medical Home
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Reference Links:
View the DOI record for The development of joint principles: integrating behavioral health care into the patient-centered medical home
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View the PubMed citation for The development of joint principles: integrating behavioral health care into the patient-centered medical home509
The development of joint principles: integrating behavioral health care into the patient-centered medical home
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: This article describes the development of the Joint Principles of The Patient-Centered Medical Home (PCMH) by the Working Party Group on Integrated Behavioral Healthcare. The Joint Principles establish the primacy of integrated behavioral health care as a core principle of the PCMH.
Topic(s):
Medical Home
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Reference Links:
View the DOI record for The development of joint principles: integrating behavioral health care into the patient-centered medical home
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View the PubMed citation for The development of joint principles: integrating behavioral health care into the patient-centered medical home511
The effects of the Maryland Medicaid Health Home Waiver on Emergency Department and inpatient utilization among individuals with serious mental illness
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
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, Medical Home
See topic collection
513
The experience of Patient Aligned Care Team (PACT) members
Type: Journal Article
Year: 2014
Abstract: BACKGROUND:: In April 2010, the Veterans Health Administration (VHA) launched the Patient Aligned Care Team (PACT) initiative to implement a patient-centered medical home (PCMH) model. Few evaluations have addressed the effects of PCMH on health care professionals' experiences. PURPOSES:: The aim of this study was to contribute to evaluation of the PACT initiative and the broader literature on PCMH by assessing respondents' experiences of implementing a PCMH model and becoming a teamlet. METHODOLOGY/APPROACH:: A retrospective qualitative analysis of open-text responses in a survey fielded to all VHA Primary Care personnel (VHA Primary Care physicians, nurse practitioners, physician assistants, nurse care managers, clinical associates, and administrative clerks) in May and June 2012 (approximately 2 years into the 5-year planned implementation of PACT) using deductive and inductive content analysis. The main measures were two open-response fields: "Is there anything else you would like us to relay to the VA leadership in Central Office?" and "Do you have any other comments or feedback on PACT?" The data consisted of free text responses of 3,868 survey participants who provided text for one or both of the open-response fields. FINDINGS:: Although respondents viewed PACT positively as a model and reported it improved relationships with patients and increased patient satisfaction, they described multiple barriers to achieving functioning teamlets and unintended consequences, including reduced time with patients, increased participant burnout, and decreased team efficacy because of low-performing team members. A central theme related to staffing being insufficient for the new model. PRACTICE IMPLICATIONS:: Insufficient staffing of PCMH teams is a critical barrier to realizing the benefits of the new model. Frontline staff have concrete recommendations for other problems, such as using back-up teams to cover during absences, but that will require providing more opportunities for feedback from staff to be heard.
Topic(s):
Education & Workforce
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, Medical Home
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Reference Links: View the PubMed citation for The experience of Patient Aligned Care Team (PACT) members
514
The future of pediatrics: Mental health competencies for pediatric primary care
Type: Journal Article
Year: 2009
Publication Place: United States
Abstract: Pediatric primary care clinicians have unique opportunities and a growing sense of responsibility to prevent and address mental health and substance abuse problems in the medical home. In this report, the American Academy of Pediatrics proposes competencies requisite for providing mental health and substance abuse services in pediatric primary care settings and recommends steps toward achieving them. Achievement of the competencies proposed in this statement is a goal, not a current expectation. It will require innovations in residency training and continuing medical education, as well as a commitment by the individual clinician to pursue, over time, educational strategies suited to his or her learning style and skill level. System enhancements, such as collaborative relationships with mental health specialists and changes in the financing of mental health care, must precede enhancements in clinical practice. For this reason, the proposed competencies begin with knowledge and skills for systems-based practice. The proposed competencies overlap those of mental health specialists in some areas; for example, they include the knowledge and skills to care for children with attention-deficit/hyperactivity disorder, anxiety, depression, and substance abuse and to recognize psychiatric and social emergencies. In other areas, the competencies reflect the uniqueness of the primary care clinician's role: building resilience in all children; promoting healthy lifestyles; preventing or mitigating mental health and substance abuse problems; identifying risk factors and emerging mental health problems in children and their families; and partnering with families, schools, agencies, and mental health specialists to plan assessment and care. Proposed interpersonal and communication skills reflect the primary care clinician's critical role in overcoming barriers (perceived and/or experienced by children and families) to seeking help for mental health and substance abuse concerns.
Topic(s):
Education & Workforce
See topic collection
, Financing & Sustainability
See topic collection
, Healthcare Disparities
See topic collection
, Healthcare Policy
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for The future of pediatrics: Mental health competencies for pediatric primary care
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View the PubMed citation for The future of pediatrics: Mental health competencies for pediatric primary care515
The group health medical home at year two: Cost savings, higher patient satisfaction, and less burnout for providers
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: As the patient-centered medical home model emerges as a key vehicle to improve the quality of health care and to control costs, the experience of Seattle-based Group Health Cooperative with its medical home pilot takes on added importance. This paper examines the effects of the medical home prototype on patients' experiences, quality, burnout of clinicians, and total costs at twenty-one to twenty-four months after implementation. The results show improvements in patients' experiences, quality, and clinician burnout through two years. Compared to other Group Health clinics, patients in the medical home experienced 29 percent fewer emergency visits and 6 percent fewer hospitalizations. We estimate total savings of $10.3 per patient per month twenty-one months into the pilot. We offer an operational blueprint and policy recommendations for adoption in other health care 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 The group health medical home at year two: Cost savings, higher patient satisfaction, and less burnout for providers
View DOI Record
View the PubMed citation for The group health medical home at year two: Cost savings, higher patient satisfaction, and less burnout for providers516
The health care home model: primary health care meeting public health goals
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: In November 2010, the American Public Health Association endorsed the health care home model as an important way that primary care may contribute to meeting the public health goals of increasing access to care, reducing health disparities, and better integrating health care with public health systems. Here we summarize the elements of the health care home (also called the medical home) model, evidence for its clinical and public health efficacy, and its place within the context of health care reform legislation. The model also has limitations, especially with regard to its degree of involvement with the communities in which care is delivered. Several actions could be undertaken to further develop, implement, and sustain the health care home.
Topic(s):
Medical Home
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Reference Links:
View the DOI record for The health care home model: primary health care meeting public health goals
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View the PubMed citation for The health care home model: primary health care meeting public health goals518
The Hope Health and Wellness Clinic: Outcomes of Individuals with Serious Mental Illness in a Bidirectional Integrated Care Clinic
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract:
The integrated health home, the Hope Health and Wellness Clinic, provides comprehensive primary and behavioral health services to adult clients of a Community Mental Health Center in Aurora, Colorado. A program evaluation of the effectiveness of this clinic was conducted over a 4 year period. Physical health data (Body Mass Index BMI, HbA1c, cholesterol, blood pressure, and waist circumference measurements) and self-report data (social connectedness, everyday functioning, psychological distress, perceived health, satisfaction with services) were tracked across time. Individuals enrolled (N = 534) experienced significant improvements over time in LDL and total cholesterol, as well as self-reported social connectedness, everyday functioning, perceived health, and psychological distress. At risk individuals demonstrated significant improvements in HDL cholesterol, triglycerides, blood pressure, tobacco and alcohol use. Individuals with serious mental illness show improvements in physical health and self-reported health after being involved in bidirectional integrated care.
Topic(s):
Healthcare Disparities
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, Medical Home
See topic collection
519
The impact of a complex care clinic in a children's hospital
Type: Journal Article
Year: 2010
Publication Place: England
Abstract: BACKGROUND: The number of medically complex and fragile children (MCFC) cared for in children's hospitals is growing, necessitating the need for optimal care co-ordination. The purpose of this study was to describe the impact of a nurse practitioner/paediatrician-run complex care clinic in a tertiary care hospital on healthcare utilization, parental and primary care provider (PCP) perceptions of care and parental quality of life. METHODS: MCFC and their parents were recruited for ambulatory follow-up by the hospital team to complement care provided by the PCP in this mixed methods single centre pre- or post-evaluative study. Parents participated in semi-structured interviews within 48 h of discharge; further data were collected at 6 and 12 months. Healthcare utilization was compared with equal time periods pre-enrolment. Parental health was assessed with the SF-36; parental perceptions of care were assessed using the Larsen's Client Satisfaction Questionnaire and the Measure of Processes of Care; PCPs completed a questionnaire at 12 months. Parental and PCP comments were elicited. Comparisons were made with baseline data. RESULTS: Twenty-six children and their parental caregivers attended the complex care clinic. The number of days that children were admitted to hospital decreased from a median of 43 to 15 days, and outpatient visits increased from 2 to 8. Mean standardized scores on the SF-36 increased (improved) for three domains related to mental health. A total of 24 PCPs responded to the questionnaire (92% response); most found the clinic helpful for MCFC and their families. Parents reported improvements in continuity of care, family-centredness of care, comprehensiveness and thoroughness of care, but still experienced frustrations with access to services and miscommunication with the team. CONCLUSION: A collaborative medical home focused on integrating community- and hospital-based services for MCFC is a promising service delivery model for future controlled evaluative studies.
Topic(s):
Medical Home
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Reference Links: View the PubMed citation for The impact of a complex care clinic in a children's hospital
520
The Impact of Alternative Payment in Chronically Ill and Older Patients in the Patient-centered Medical Home
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: BACKGROUND: Patient-centered medical home (PCMH) has gained prominence as a promising model to encourage improved primary care delivery. There is a paucity of studies that evaluate the impact of payment models in the PCMH. OBJECTIVES: We sought to examine whether coupling coordinated, team-based care transformation plan with a novel reimbursement model affects outcomes related to expenditures and utilization. RESEARCH DESIGN: Interrupted time-series model with a difference-in-differences approach to assess differences between intervention and control groups, across time periods attributable to PCMH transformation and/or payment change. RESULTS: Although results were modest and mixed overall, PCMH with payment reform is associated with a reduction of $1.04 (P=0.0347) per member per month (PMPM) in pharmacy expenditures. Patients with hypertension, hyperlipidemia, diabetes, and coronary atherosclerosis enrolled in PCMH without payment reform experienced reductions in emergency department visits of 2.16 (P<0.0001), 2.42 (P<0.0001), 3.98 (P<0.0001), and 3.61 (P<0.0001) per 1000 per month. Modest increases in inpatient admission were seen among these patients in PCMH either with or without payment reform. Patients 65 and older enrolled in PMCH without payment reform experienced reductions in pharmacy expenditures $2.35 (P=0.0077) PMPM with a parallel reduction in pharmacy standardized cost of $2.81 (P=0.0174) PMPM indicative of a reduction in the intensity of drug utilization. CONCLUSIONS: We conclude that PCMH implementation coupled with an innovative payment arrangement generated mixed results with modest improvements with respect to pharmacy expenditures, but no overall financial improvement. However, we did see improvement within specific groups, especially older patients and those with chronic conditions.
Topic(s):
Financing & Sustainability
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for The Impact of Alternative Payment in Chronically Ill and Older Patients in the Patient-centered Medical Home
View DOI Record
View the PubMed citation for The Impact of Alternative Payment in Chronically Ill and Older Patients in the Patient-centered Medical Home