Presenters
- Rachelle Rene, PhD, BCB, HSMI, Director of Primary Care Integrated Behavioral Health, Clinical Assistant Professor, Philadelphia, PA
- Mollie Cherson, LCSW, Behavioral Health Consultant, Family Practice of Willow Grove, Abington, PA
- Angelo Rannazzisi, PsyD, Behavioral Health Consultant, Jefferson Family Medicine Associate, Philadelphia, PA
- Amy Cunningham, PhD, MPH, Department of Family and Community Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
- Christine Marschilok, MD, Clinical Assistant Professor of Family Medicine & Sports Medicine, Philadelphi
- Alexis Silverio MPH, CSCS, CHES, NASM-FNS
Summary
The U.S. healthcare system has experienced a paradigm shift in the way it delivers care since the implementation of the Affordable Care Act. Its emphasis on improving the health of the population, enhancing the experience and outcomes of the patient, and reducing per capita cost of care for the benefit of communities (the Triple Aim for populations) has created opportunities and challenges for numerous health care entities, especially for those that have not implemented an integrated behavioral health component. Providers have also faced challenges in fulfilling the Triple Aim, leading to calls for a Quadruple Aim that includes a focus on provider well-being. Even prior to the COVID-19 global pandemic, the primary care setting has been the de facto mental health provider for many, treating and managing most patients with depression and anxiety diagnoses (Kessler & Stafford, 2008). For this reason, integrated behavioral health care with the use of Primary Care Behavioral Health (PCBH) Model has been an effective tool care and treatment of mental health diagnosis including, not limited to, depression and anxiety (Robinson & Reiter, 2016; Linde, et al., 2015) and bringing traditional psychotherapy treatment modalities to the primary care setting (Sawchuk, et al., 2020). Since the emergence of COVID-19, growing research shows evidence of a continued burden to the primary care setting in meeting the mental health needs of affected communities (Kanzler & Ogbeide, 2020; Rajkumar, 2020). Additionally, the pandemic has altered the health care service delivery. Given the nature of how COVID-19 is transmitted, patients have been encouraged to attend visits via telemedicine videoconferencing or phone sessions in order to limit community spread. Jefferson Health has continued to grow PCBH throughout sixty primary care practices with the transition to telemedicine due to the COVID-19 pandemic. Like many others working in integrated health care Jefferson Health has had many successes with the transition along with finding areas of continued growth and improvement as the future of patient care continues to evolve. The transition to telemedicine has enabled Jefferson Health to leverage the virtual platform to reduce disparity by expanding access to behavioral health services to patients across its southern New Jersey and Southeastern Pennsylvania campuses. Initial outcome metrics of the transition to telemedicine and a hybrid model of services have reflected continued impact of serving the community through PCBH with depression and anxiety as measured by the PHQ9 and GAD7; improving Jefferson employee well-being, and expanded options for long-term program financial sustainability. This hybrid transition has fundamentally transformed how team-based care is delivered at Jefferson Health and could offer valuable lessons to other organizations looking to implement a similar model.
Objectives
- Define key metrics used in evaluating Jefferson's PCBH program
- Define Telemedicine resources and discuss its continued benefit to providing patient care
- Discuss the impact, successes, challenges and ongoing outcomes of embedding BHCs within 60 primary care practices