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Title and Citation
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Summary
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Format
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Behavioral Health as Primary Care: Beyond Efficacy to Effectiveness Cummings, N.A., O'Donohue, W., and Ferguson, K.E. (Eds.). Behavioral Health As Primary Care: Beyond Efficacy to Effectiveness . Reno, NV: Context Press. 2003.
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Integrated care, defined as the better coordination of behavioral health services with medical services, holds much promise in addressing the above problems. One of the key advantages to this healthcare delivery system is that it can reduce demand for healthcare by providing patients with the healthcare they actually need. There is significant clinical research all pointing to one fact: many patients (perhaps even the majority) receiving traditional primary care or specialty care medicine also need behavioral care.
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Web Access to Purchase
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Building Medical Homes: Lessons from Eight State with Emerging Programs Kaye, N., Buxbaum, J., and Takach, M. Building Medical Homes: Lessons From Eight States With Emerging Programs, The Commonwealth Fund and the National Academy for State Health Policy, December 2011.
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Eight states profiled in this report are at different stages in the development and implementation of PCMH programs and have relied on different strategies to encourage adoption of the model. Their experiences demonstrate that states can play a critical role in helping practices improve performance and can productively address systemic barriers such as those that can lead to conflict among payers.
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PDF
(550 KB)
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Changes Involved in Patient-Centered Medical Home Transformation Wagner, E.H., Coleman, K., Reid, R. J. et al. "The Changes Involved in Patient-Centered Medical Home Transformation,"Primary Care: Clinics in Office Practice, June 2012 39(2):241-59.
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The patient-centered medical home model has been proposed by the major primary care professional societies as a way to achieve more effective, less costly care. Commonwealth Fund-supported researchers reviewed the professional literature and convened a panel of experts to identify characteristics of fully transformed medical homes and the necessary changes to infrastructure, organization, and care delivery that practices and clinicians must make to get there. (Only the abstract is in the public domain.)
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Web Access
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Growing Your Own: Community Health Workers and Jobs to Careers Farrar, B., Morgan, J.C., Chuang, E., Konrad, T.R. Growing Your Own: Community Health Workers and Jobs to Careers. Journal Ambul Care Manage 34(3):234-46. Jul/Sep 2011.
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Quantitative and qualitative case study data demonstrate that investing in CHWs can achieve measurable worker and programmatic outcomes. To achieve these outcomes, targeted changes were made to the structure, culture, and work processes of employing organizations. These findings have implications for other health care employers interested in developing their CHW workforce. (Only the abstract is in the public domain.)
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Web Access
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Integrating Behavioral Health and Primary Care Services: Opportunities and Challenges for State Mental Health Authorities Mauer, B. Integrating Behavioral Health And Primary Care Services: Opportunities and Challenges for State Mental Health Authorities. Eleventh Technical Report, NASMHPD, 2005.
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The National Association of State Mental Health Program Directors (NASMHPD) Medical Directors Council commissioned this overlay analysis of The Four Quadrant Clinical Integration Model and The Care Model approaches to integrated healthcare to establish baseline data on states' implementation of and to elicit recommendations in the areas of: Community Health Centers and their role in providing behavioral health services; needs of the people served by state mental health authorities; and evidence for integrating behavioral health services into primary care.
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(510 KB)
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Integrating Primary Care & Mental Health-Substance Use Moczygemba, L.R., Goode, J.R., Gatewood, S.B.S., Osborn, R.D., Alexander , A.J., Kennedy, A.K., Stevens, L.P., and Matzke, G.R. Integration of Collaborative Medication Therapy Management in a Safety Net Patient-Centered Medical Home. JAPhA V. 51(2) March-April 2011. pp. 167-172.
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The objective of this review was to describe the integration of collaborative medication therapy management (CMTM) into a safety net PCMH. Researchers studied a FQCH for homeless individuals over a 21-month period. Reviewers found that integrated CMTM was a valuable patient-centered strategy for addressing medication-related problems among homeless individuals. (Abstract only in public domain.
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Physician "Costs" in Providing Behavioral Health in Primary Care Meadows, T., Valleley, R., Haack, M.K., Thorson, R., and Evans J. Physician "costs" in Providing Behavioral Health in Primary Care. Clin Pediatr (Phila). 2011 May; 50(5):447-55. Epub 2010 Dec 30.
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Previous research has shown that behavioral health concerns lengthen primary care visits. This study is the first to quantify those effects on pediatrician reimbursement. Integrating behavioral health services allows physicians to refer patients with behavioral issues to in-house specialists. These, in turn, can address the behavioral health issue and are licensed to receive mental health reimbursement. (Only the abstract is in the public domain.)
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Web Access
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Recommended Core Measures for Evaluating the Patient-Centered Medical Home: Cost, Utilization, and Clinical Quality Rosenthal, M.B., Abrams, M.K., Bitton, A. and the Patient-Centered Medical Home Evaluators' Collaborative. Recommended Core Measures for Evaluating the Patient-Centered Medical Home: Cost, Utilization, and Clinical Quality, The Commonwealth Fund, May 2012.
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Initiatives across the country are testing the promise of the medical home model. To properly evaluate and compare results that will aid in the implementation of these and other initiatives, researchers need a standard set of core measures. This brief describes the process and recommendations of more than 75 researchers who came together to identify a core set of standardized measures to evaluate the patient-centered medical home. The focus is on two domains of medical home outcomes: cost/utilization and clinical quality.
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(1 MB)
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Transforming Community Health Centers into Patient-Centered Medical Homes: The Role of Payment Reform Ku, L., Shin, P., Jones, E., and Bruen, B. Transforming Community Health Centers into Patient-Centered Medical Homes: The Role of Payment Reform. The Commonwealth Fund, September 2011.
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This report examines how changes in the way federally qualified health centers (FQHCs) are financed could support the transformation of these critical safety-net providers into high performing patient-centered medical homes. Through surveys and interviews, the authors explore the current landscape of health center involvement in medical home initiatives, adoption of medical home standards, and receipt of payment incentives. Based on their findings, the authors make preliminary recommendations to encourage health centers to serve as patient- and community-centered medical homes.
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(430 KB)
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Triple AIM Journey: Improving Population Health and Patients' Experience of Care, While Reducing Costs McCarthy, D. The Triple AIM Journey: Improving Population Health and Patients' Experience of Care, While Reducing Costs, in Case Study, Case Study Series Introduction and Overview. The Commonwealth Fund. July 2010.
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Case studies of three organizations participating in the Institute for Healthcare Improvement's Triple Aim initiative shed light on how they are partnering with provid¬ers and organizing care to improve the health of a population and patients' experience of care while lowering-or at least reducing the rate of increase in-the per capita cost of care.
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(600 KB)
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