Now is a great time to integrate primary care and behavioral health
not just in terms of policy but probably more importantly in terms
of the impact policy has on the actual care that patients receive.
We're seeing collaborative care unfold at a unprecedented pace all
across the country, every geographic region that you can think of is
doing something to integrate primary care and behavioral health.
From the Northwest region all the way to the other side of the country
in Florida, I've been amazed at the progress in just such a short amount
of time and this is a direct result of both policies as well as personal
feet on the ground incentives to do the right thing for patients.
And I think what's very exciting is the work around acknowledging how
much mental health is essential in primary care and how much primary care is essential in mental health.
There are some very important opportunities to integrate primary
care and behavioral health right now especially with the acceleration
across the country of the patient centered medical home,
the accountable care organization, and then some of the really
important statewide comprehensive primary care initiatives that are taking place
in a number of states with the intentions of expanding across the country.
So when I think of primary care and when I think of the word
comprehensive I really think behavioral health, mental health,
and especially a more comprehensive view of the patient is what these policies are trying to aim for.
So a great example of a current policy in place right now is this movement
towards understanding how we can better treat what we call episodes of care or bundled care.
And all that really means is that instead of saying well this patient
has heart disease and so let's focus intensively on this hospitalization
around heart disease we actually are creating both financial incentives,
as well as quality measures that look at you know what,
we know that a good number of patients with heart disease also
have potentially depression or other behavioral health issues,
how do we bring the right group of providers to come together to deal with this?
That's true collaborative care.
A lot of people wonder why healthcare policy matters and I like
to explain it this way, healthcare policy is really our basic infrastructure.
It's our highway for how we think about the healthcare system and it's
the backbone upon which we can build and do what I think people like myself,
who practice in a primary care setting, actually want to concentrate on.
And that's delivering care.
I would say to you that a lot of what we're seeing in developments in
collaborative care come from people like the folks that I've been
privileged to work around who really get it and understand it and are
just so thankful that now we have policies in place to promote this kind of care.
We still have a lot of people in our country and that includes many
providers who just don't understand what their role is.
And so some of the research that's going on right now with the,
with the assistance and support of agencies like AHRQ are critical to
helping us show some of these providers who just don't see a path
forward that they too can practice collaborative care and that they can
still retain some of their individual autonomy,
and some of their cognitive ability in their specialties.
We need to show that more than ever now.