title: Delivering On Accountable Care: Lessons From A Behavioral Health Program To Improve Access And Outcomes.
abstract: Patients with behavioral health disorders often have worse health outcomes and have higher health care utilization than patients with medical diseases alone. As such, people with behavioral health conditions are important populations for accountable care organizations (ACOs) seeking to improve the efficiency of their delivery systems. However, ACOs have historically faced numerous barriers in implementing behavioral health population-based programs, including acquiring reimbursement, recruiting providers, and integrating new services. We developed an evidence-based, all-payer collaborative care program called Behavioral Health Associates (BHA), operated as part of UCLA Health, an integrated academic medical center. Building BHA required several innovations, which included using our enterprise electronic medical record for behavioral health referrals and documentation; registering BHA providers with insurance plans' mental health carve-out products; and embedding BHA providers in primary care practices throughout the UCLA Health system. Since 2012 BHA has more than tripled the number of patients receiving behavioral health services through UCLA Health. After receiving BHA treatment, patients had a 13 percent reduction in emergency department use. Our efforts can serve as a model for other ACOs seeking to integrate behavioral health care into routine practice.
authors: Robin M. A. Clarke (rclarke@mednet.ucla.edu) is an assistant clinical professor in the Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA), and is the medical director for quality for the UCLA Faculty Practice Group, in Los Angeles.
authors: Robin M A
authors: RM
authors: Clarke
authors: Jessica Jeffrey is a health sciences clinical assistant professor in the Department of Psychiatry, David Geffen School of Medicine, UCLA.
authors: Jessica
authors: J
authors: Jeffrey
authors: Mark Grossman is a clinical professor in the Departments of Medicine and Pediatrics, David Geffen School of Medicine, UCLA.
authors: Mark
authors: M
authors: Grossman
authors: Thomas Strouse is a professor in the Department of Psychiatry, David Geffen School of Medicine, and is chief medical officer of the Stewart and Lynda Resnick Neuropsychiatric Hospital, both at UCLA.
authors: Thomas
authors: T
authors: Strouse
authors: Michael Gitlin is a professor in the Department of Psychiatry, David Geffen School of Medicine, and is director of the Adult Division of Psychiatry at the Resnick Neuropsychiatric Hospital, both at UCLA.
authors: Michael
authors: M
authors: Gitlin
authors: Samuel A. Skootsky is a professor in the Department of Medicine, David Geffen School of Medicine, UCLA, and is chief medical officer of the UCLA Faculty Practice Group and Medical Group.
authors: Samuel A
authors: SA
authors: Skootsky
mesh_terms: D000046:Academic Medical Centers; D060866:Accountable Care Organizations / Q000458:organization & administration*; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016730:Program Development; D015397:Program Evaluation; D012189:Retrospective Studies; D014481:United States
keywords: Financing Health Care; Health Reform; Mental Health/Substance Abuse; Organization and Delivery of Care; Primary Care