C10 – Implementation & Expansion of the Integrated Behavioral Health Plus (IBH+) Services Model in Colorado

Summary

Background: Since 2014, the University of Colorado Department of Family Medicine (CU DFM) leveraged technology and provider relationships to expand access to mental health expertise through a stepped, hybrid (virtual and in-person), team-based, integrated service. In 2020, in collaboration with the CU Department of Psychiatry, an enhanced behavioral health integration model developed, further incorporating telepsychiatry consultation (referred to as IBH+) and began scaling from 1 clinic into 7 IBH+ Family Medicine practices, specifically targeting access to our Medicaid patient population. This presentation describes the IBH+ model and reports on staffing and service delivery metrics tracked in a program dashboard. Study Design: Quality improvement Description of Population: 60,000 patients in 7 CU-affiliated family medicine practices. Procedures/ Data Collection: A Microsoft Excel dashboard serves to track project metrics and is updated monthly and quarterly through a shared electronic medical record, Epic. Key Results: As of March 2021, 3 practices adopted the full IBH+ service and e-consults expanded to 7 practices. Access to team-based care increased, adding 4.0 FTE psychology, 0.7 FTE psychiatrist, and 0.1 FTE addiction medicine. As a result, the number of patient encounters increased from 331 in July to 649 in February. During the first six months (July-December 2020), 203 unique Medicaid patients received at least one IBH+ service. Between July 2020 and February 2021, 3,388 psychology and 199 telepsychiatry visits were provided and 49 e-Consults were answered. Month-over-month increases in service delivery averages an increase in 48 patient encounters/month for telepsychiatry, in-person psychology and telepsychology. Conclusions: The IBH+ model has been successfully ramped up over 9 months and services are tracked in an ongoing dashboard. Focusing our team-based, telepsychiatry model on our Medicaid population promotes health equity for all patients.