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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).
1286 Results
1141
The Impact Of Medicare ACOs On Improving Integration And Coordination Of Physical And Behavioral Health Care
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: The accountable care organization (ACO) model holds the promise of reducing costs and improving the quality of care by realigning payment incentives to focus on health outcomes instead of service volume. One key to managing the total cost of care is improving care coordination for and treatment of people with behavioral health disorders. We examined qualitative data from ninety organizations participating in Medicare ACO demonstration programs from 2012 through 2015 to determine whether and how they focused on behavioral health care. These ACOs had mixed degrees of engagement in improving behavioral health care for their populations. The biggest challenges included a lack of behavioral health care providers, data availability, and sustainable financing models. Nonetheless, we found substantial interest in integrating behavioral health care into primary care across a majority of the ACOs.
Topic(s):
Education & Workforce
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, Financing & Sustainability
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Reference Links: 
View the DOI record for The Impact Of Medicare ACOs On Improving Integration And Coordination Of Physical And Behavioral Health Care
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View the PubMed citation for The Impact Of Medicare ACOs On Improving Integration And Coordination Of Physical And Behavioral Health Care1143
The Impact of the Covid-19-Related Transition to Telehealth on Visit Adherence in Mental Health Care: An Interrupted Time Series Study
Type: Journal Article
Year: 2022
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
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, HIT & Telehealth
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, Opioids & Substance Use
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1144
The importance of assessing where colocation is occurring. Commentary on Richman, Lombardi, and Zerden (2020)
Type: Journal Article
Year: 2020
Publication Place: United States
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
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Reference Links:
View the DOI record for The importance of assessing where colocation is occurring. Commentary on Richman, Lombardi, and Zerden (2020)
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View the PubMed citation for The importance of assessing where colocation is occurring. Commentary on Richman, Lombardi, and Zerden (2020)1145
The importance of time in treating mental health in primary care
Type: Journal Article
Year: 2011
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 importance of time in treating mental health in primary care
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View the PubMed citation for The importance of time in treating mental health in primary care1148
The integrated behavioral health service delivery system model
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: Costs and effective management of health care in general, and behavioral health care in particular, have been of primary importance and concern to federal, state, and local governments. With the passage of Health Care Reform (HCR) these concerns will only escalate. Thus, the necessity for the development of innovative, successful, and integrated cost-effective treatments and procedures is evident. The behavioral health care model presented here is proposed to address these needs. The model centers on the composition of effective psychosocial treatment and provides a cost analysis of social work and its services. By defining the problems that need to be addressed in health care management and cost containment, and applying findings of evidence-based studies, this article provides an effective model for health care organizations. It also presents a profile of the behavioral health social worker, defining the requisite abilities for effectiveness in the role and looking at the key impact areas for a behavioral health model. This comprehensive guide will prepare new social workers entering health care organizations as well as provide a valuable reference for existing social workers, academics, and practitioners of behavioral health care.
Topic(s):
Healthcare Policy
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, Financing & Sustainability
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, Education & Workforce
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Reference Links:
View the DOI record for The integrated behavioral health service delivery system model
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View the PubMed citation for The integrated behavioral health service delivery system model1150
The medical home as a mediator of the relation between mental health symptoms and family burden among children with special health care needs
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: OBJECTIVE: This study explores the role of medical home as a mediator of the relationship between emotional and behavioral difficulties among CSHCN and financial- and employment-related burden experienced by their families. METHODS: Data were obtained from the 2005-2006 NS-CSHCN, a nationally representative cross-sectional survey of 40 465 CSHCN. Family burden was measured using parent-reported financial problems and changes in family member employment resulting from the child's needs. Emotional and behavioral symptoms were reported by parents using 3 binary items capturing difficulty with depression, anxiety, disordered eating, and emotional or behavior problems. Medical home was measured according to the framework of the American Academy of Pediatrics. Bivariate and multivariate analyses were used to explore the role of medical home in the relation between mental health symptoms and family burden. RESULTS: A smaller proportion of CSHCN with emotional or behavioral difficulties had a medical home or related components compared to CSHCN generally, and a greater proportion of their families experienced burdens. Multivariate analyses showed that the mediated effect of care coordination on the relation between emotional or behavioral symptoms and family burden explained 18% to 35% of the total effect of these symptoms on financial problems and employment changes. Overall medical home access explained 16% to 28% of the total effect of symptoms on burden. CONCLUSIONS: Medical home access, and care coordination in particular, may partially mediate the relation between emotional and behavioral symptoms and financial hardship. Future efforts to implement the medical home model may benefit from an increased focus on care coordination as a means of reducing these burdens.
Topic(s):
Financing & Sustainability
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, Medical Home
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1151
The medical home, preventive care screenings, and counseling for children: Evidence from the Medical Expenditure Panel Survey
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: OBJECTIVE: Little is known about the role of the medical home in promoting essential preventive health care services in the general pediatric population. This study examined associations between having a medical home and receipt of health screenings and anticipatory guidance. METHODS: We conducted a cross-sectional analysis of the 2004-2006 Medical Expenditure Panel Survey (MEPS). Our sample included 21 055 children aged 0 to 17 years who visited a health care provider in the year prior to the survey. A binary indicator of the medical home was developed from 22 questions in MEPS, reflecting 4 of the 7 American Academy of Pediatrics' recommended components of the medical home: accessible, family-centered, comprehensive, and compassionate care. Multivariable logistic regression was used to examine the association between the medical home and receipt of specific health screenings and anticipatory guidance, controlling for confounding variables. RESULTS: Approximately 49% of our study sample has a medical home. The medical home, defined when the usual source of care is a person or facility, is significantly associated with 3 health screenings (ie, weight, height, and blood pressure) and several anticipatory guidance topics (ie, advice about dental checkups, diet, exercise, car and bike safety), with odds ratios ranging from 1.26 to 1.54. CONCLUSIONS: The medical home is associated with increased odds of children receiving some health screenings and anticipatory guidance. The medical home may provide an opportunity to improve the delivery of these services for children.
Topic(s):
Financing & Sustainability
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, Medical Home
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1152
The mental health of doctor-shoppers: experience from a patient-led fee-for-service primary care setting
Type: Journal Article
Year: 2011
Publication Place: Netherlands
Topic(s):
Financing & Sustainability
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Reference Links:
View the DOI record for The mental health of doctor-shoppers: experience from a patient-led fee-for-service primary care setting
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View the PubMed citation for The mental health of doctor-shoppers: experience from a patient-led fee-for-service primary care setting1153
The mental health/primary care interface in the United States: history, structure, and context
Type: Journal Article
Year: 2002
Publication Place: United States
Abstract: This paper, the first in a series commissioned by NIMH for the "Challenges for the 21st Century: Mental Health Services Research Conference," seeks to provide a broad perspective on the primary care/mental health interface in the United States. The manuscript examines both the care of mental disorders in medical settings, and also the medical care of the seriously medically ill. The first section provides a historical overview of the cycling patterns of growth and retrenchment of primary care medicine during the 20th century, and the how those changes have paralleled the care of mental disorders and the mentally ill. The second section examines the four core features of primary care -first contact, longitudinality, comprehensiveness and coordination -and their implications for these issues. An historical and system-level perspective can provide a crucial step towards improving care on the mental health/primary care interface.
Topic(s):
Financing & Sustainability
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Reference Links: View the PubMed citation for The mental health/primary care interface in the United States: history, structure, and context
1156
The occasional case against broad dissemination and implementation: retaining a role for specialty care in the delivery of psychological treatments
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
Education & Workforce
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, Financing & Sustainability
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1157
The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: BACKGROUND: Hypochondriasis is prevalent in primary care, but the diagnosis is hampered by its stigmatizing label and lack of valid diagnostic criteria. Recently, new empirically established criteria for Health anxiety were introduced. Little is known about Health anxiety's impact on longitudinal outcome, and this study aimed to examine impact on self-rated health and health care costs. METHODOLOGY/PRINCIPAL FINDINGS: 1785 consecutive primary care patients aged 18-65 consulting their family physicians (FPs) for a new illness were followed-up for two years. A stratified subsample of 701 patients was assessed by the Schedules for Clinical Assessment in Neuropsychiatry interview. Patients with mild (N = 21) and severe Health anxiety (N = 81) and Hypochondriasis according to the DSM-IV (N = 59) were compared with a comparison group of patients who had a well-defined medical condition according to their FPs and a low score on the screening questionnaire (N = 968). Self-rated health was measured by questionnaire at index and at three, 12, and 24 months, and health care use was extracted from patient registers. Compared with the 968 patients with well-defined medical conditions, the 81 severe Health anxiety patients and the 59 DSM-IV Hypochondriasis patients continued during follow-up to manifest significantly more Health anxiety (Whiteley-7 scale). They also continued to have significantly worse self-rated functioning related to physical and mental health (component scores of the SF-36). The severe Health anxiety patients used about 41-78% more health care per year in total, both during the 3 years preceding inclusion and during follow-up, whereas the DSM-IV Hypochondriasis patients did not have statistically significantly higher total use. A poor outcome of Health anxiety was not explained by comorbid depression, anxiety disorder or well-defined medical condition. Patients with mild Health anxiety did not have a worse outcome on physical health and incurred significantly less health care costs than the group of patients with a well-defined medical condition. CONCLUSIONS/SIGNIFICANCE: Severe Health anxiety was found to be a disturbing and persistent condition. It is costly for the health care system and must be taken seriously, i.e. diagnosed and treated. This study supports the validity of recently introduced new criteria for Health anxiety.
Topic(s):
Financing & Sustainability
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, Medically Unexplained Symptoms
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Reference Links:
View the DOI record for The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health
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View the PubMed citation for The outcome of health anxiety in primary care. A two-year follow-up study on health care costs and self-rated health1158
The patient-centered medical home model: healthcare services utilization and cost for non-elderly adults with mental illness
Type: Journal Article
Year: 2018
Publication Place: England
Abstract: BACKGROUND: The patient-centered medical home (PCMH) model is designed to improve health outcomes while containing the cost of care. However, the evidence is inconclusive. AIMS: The aim of this study was to examine the associations between receipt of care consistent with the PCMH and healthcare services utilization and expenditures for non-elderly adults with mental illness in the USA. METHOD: A surveillance study was conducted using self-reported data for 6908 non-elderly adults with mental illness participating in the 2007-2012 Medical Expenditure Panel Survey. Healthcare services utilization and expenditures were compared for study participants who received care consistent with the PCMH, participants with a non-PCMH usual source of care (USC), and participants without a USC. RESULTS: Differences in utilization and expenditures between participants who received care consistent with the PCMH and participants who had a non-PCMH USC were not statistically significant for any healthcare services category. CONCLUSIONS: Receipt of care consistent with the PCMH was not significantly associated with differences in healthcare services utilization or expenditures compared to having a non-PCMH USC. Research assessing whether the PCMH is cost-effective for non-elderly adults with mental illness is needed.
Topic(s):
Financing & Sustainability
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, Medical Home
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1160
The Perceived Impact of 42 CFR Part 2 on Coordination and Integration of Care: A Qualitative Analysis
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: OBJECTIVE: Title 42 of the Code of Federal Regulations Part 2 (42 CFR Part 2) controls the release of patient information about treatment for substance use disorders. In 2016, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a proposed rule to update the regulations, reduce provider burdens, and facilitate information exchange. Oregon's Medicaid program (Oregon Health Plan) altered the financing and structure of medical, dental, and behavioral care to promote greater integration and coordination. A qualitative analysis examined the perceived impact of 42 CFR Part 2 on care coordination and integration. METHODS: Interviews with 76 stakeholders (114 interviews) conducted in 2012-2015 probed the processes of integrating behavioral health into primary care settings in Oregon and assessed issues associated with adherence to 42 CFR Part 2. RESULTS: Respondents expressed concerns that the regulations caused legal confusion, inhibited communication and information sharing, and required updating. Addiction treatment directors noted the challenges of obtaining patient consent to share information with primary care providers. CONCLUSIONS: The confidentiality regulations were perceived as a barrier to care coordination and integration. The Oregon Health Authority, therefore, requested regulatory changes. SAMHSA's proposed revisions permit a general consent to an entire health care team and allow inclusion of substance use disorder information within health information exchanges, but they mandate data segmentation of diagnostic and procedure codes related to substance use disorders and restrict access only to parties with authorized consent, possibly adding barriers to the coordination and integration of addiction treatment with primary care.
Topic(s):
Financing & Sustainability
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, Healthcare Policy
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, Opioids & Substance Use
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Reference Links:
View the DOI record for The Perceived Impact of 42 CFR Part 2 on Coordination and Integration of Care: A Qualitative Analysis
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View the PubMed citation for The Perceived Impact of 42 CFR Part 2 on Coordination and Integration of Care: A Qualitative Analysis