- Rachelle Rene, PhD, BCB, HSMI, Director of Primary Care Integrated Behavioral Health, Jefferson Health/Thomas Jefferson University, Philadelphia, PA
- Mollie Cherson, MPhil, LCSW, Lead Behavioral Health Consultant, Abington Jefferson Health, Abington, PA
- Angelo Rannazzisi, PsyD, Lead Behavioral Health Consultant, Jefferson Family Medicine Associate, Philadelphia, PA
- Lori Merkel, MSPH, RN, CPHQ, Population Health Business Analyst, Jefferson Medical Group, Abington, PA
- Christine Marschilok, MD, Physician, Thomas Jefferson University, Philadelphia, PA
- Amy Cunningham, PhD, MPH, Research Assistant Professor Thomas Jefferson University, Philadelphia, PA
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)1 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.2 The benefits of integrating a behavioral health consultant in the primary care setting are well established. Sixty (60) Jefferson Health primary care practices were accepted into the Center for Medicare and Medicaid’s (CMS) 5-year Comprehensive Primary Care Plus (CPC+) demonstration program (2017-2021). CPC+ selects practices that have demonstrated a solid track record of practice transformation and have demonstrated advanced capacity and readiness for enhanced care delivery. Through CPC+, Jefferson has had the opportunity to rapidly scale up system-wide primary care integrated behavioral health (PCIBH) model.3 This included the hiring and embedding over 25 Behavioral Health Consultants across four regional areas throughout Pennsylvania and New Jersey. Initial outcome metrics have reflected a fundamental transformation in how primary care providers at Jefferson understand and deliver integrated, team-based care within the practices, improved patient outcomes for depression and anxiety as measured by the PHQ9-and GAD7; improved physician well-being and expanded options for long-term program financial sustainability. This approach has fundamentally transformed how team-based care is delivered at Jefferson and could offer valuable lessons to other organizations looking to implement a similar model.
- Define CPC+ and implementation of the PCBH model at a large academic health center
- Define key metrics used in evaluating Jefferson's PCBH program.
- Discuss the impact, successes, challenges and early outcomes of embedding BHCs within 60 primary care practices