Grants awarded to support integration of behaviora

Grants awarded to support integration of behavioral health in primary care practices

Independent Health Foundation and The Primary Connection collaborate on two-year program to coordinate care for mental health and substance abuse in primary care physician offices

Buffalo, N.Y., Jan. 21, 2015 - The Peter and Elizabeth C. Tower Foundation and The John R. Oishei Foundation have awarded the Independent Health Foundation a total of $736,000 in grants to fund an innovative behavioral health program with eight community-based primary care physician practices.

The overall goal of the program is to improve access to behavioral health care, including mental health and substance abuse, by integrating licensed behavioral health specialists within the primary care setting.

The grants help cover the costs of the collaborative effort, with additional funding by Independent Health and the primary care practices.

“We are extremely grateful for the Tower and Oishei foundations for recognizing the importance of this initiative,” said Judith Feld, M.D., Independent Health Foundation board member and medical director for behavioral health at Independent Health. “There is clear evidence that shows the need for behavioral health services in the primary care setting. This funding enables the practices to hire licensed mental health counselors as primary behavioral health care consultants to work as full-time employees as part of the primary care team.”

“Behavioral and mental health problems are becoming increasingly more common in our pediatric offices,” said Maureen Montgomery, M.D., Amherst Pediatrics. “Unlike most physical health symptoms, behavioral health concerns are likely to be complex and chronic, requiring a level of care and expertise which is difficult to mesh into a busy office schedule. Having a mental health expert in our office means that children and parents have immediate access to care. It also means that pediatricians can coordinate physical and mental health care simultaneously, thus reducing the stigma associated with mental health problems, and outcomes are improved.”

“The Oishei and Tower Foundations, as well as Independent Health Foundation and the physician practices, should be commended for dedicating funding and resources to improve access to behavioral health care,” said Gale R. Burstein, MD, MPH, FAAP, Erie County Commissioner of Health. “Expanded access to mental health and substance abuse services is so critically needed in our community. This effort to place behavioral health specialists in primary care settings will help people receive the right care at the time they need it.”

Studies have found a majority of patients experiencing mild to moderate mental health and behavioral health problems have indicated a strong preference for receiving treatment for these problems within the primary care setting. However, although the majority of individuals with a behavioral health disorder visit their primary care physicians each year, fewer than 33 percent of them receive treatment for their conditions.

"There have been a number of initiatives across the country to support multi-stakeholder collaboration in the treatment of depression in primary care,” said Dr. Feld. “Those initiatives demonstrated success in improving care and also highlighted significant barriers when implementing these models on a larger scale."

The barriers include reimbursement constraints in the fee-for-service model, stigma, limited mental health training in primary care and a fragmented medical culture.

This program builds on the successes while also addressing the barriers the other initiatives encountered. Components of this program include:
  • Training mental health providers to work in a primary care setting;
  • Training the primary care team in collaborating with their new team members;
  • Psychiatric consultation to support the practices.

In addition, the Independent Health Foundation will serve as a connection to urban-based practices through its Good for the Neighborhood initiative, which provides health and wellness programs in neighborhoods where access to health care is limited. Health care providers who identify individuals with behavioral health needs through the Good for the Neighborhood program will be able to refer them to their primary care physician.

“Primary care is a gateway to behavioral health services, so it's incredibly important to support physicians with training and additional capacity to meet behavioral health needs,” said Don Matteson, chief program officer, The Peter and Elizabeth C. Tower Foundation. “We believe that with more integration into primary care, more people will be able to manage their behavioral health conditions and have a better quality of life.”

“It is critically important that behavioral health be treated as part of primary care, and not separately, since all evidence points to the benefits of an integrated approach,” said Robert D. Gioia, president of The John R. Oishei Foundation. “The Foundation has been working on this kind of integrated approach for some time with our colleagues, and we are happy to have a good model to support.”

The eight participating physician offices are part of The Primary Connection, a physician-led initiative that takes a coordinated approach to enhancing quality, access and affordability across the entire health care continuum. The Primary Connection includes 30 practices, representing more than 190 high performing physicians who treat approximately 93,000 Independent Health members across Western New York. It is the largest local groundbreaking effort that spans the entire health care system of its kind.

The grant funding allows the behavioral health services to be provided to all patients within the primary care practice, regardless of a patient’s insurer. Traditional fee-for-service reimbursement methods do not recognize services above and beyond the office visit, especially coordination of services, required for comprehensive care. During the program, new reimbursement models are being developed and will be assessed to support the continued sustainability of integrated behavioral health. Additional strengths of the program include a strong community focus, customized practice interventions and a sustainable business model.

Program metrics will include improvement in outcomes of targeted chronic health conditions, improvement in functional capacity for individuals with mental health and substance abuse disorders, as well as the cost impact of the intervention through analyzing level of care utilization and total cost of care.

“The primary care setting is a space that is already familiar and comfortable and will ensure that individuals with behavioral health concerns receive the care they need,” Dr. Feld said. “Given that most people will access a primary care setting first, it becomes optimal to engage with patients within the primary care practice and integrate care to meet all of the individual’s physical and behavioral health needs.”

“We hope this model can serve as a template for community-based behavioral health integration implementation in diverse health care delivery systems,” Dr. Feld said.

The primary care practices participating in the program include:
  • Amherst Pediatrics
  • Wheatfield Pediatrics
  • Williamsville Pediatrics
  • Western New York Pediatrics
  • Buffalo Medical Group
  • Jericho Road Community Health Center
  • Lifetime Health Medical Group, Amherst Health Center
  • Pembroke Family Medicine
About The John R. Oishei Foundation

The John R. Oishei Foundation strives to be a catalyst for change to enhance economic vitality and quality of life for the Buffalo Niagara region through grantmaking, leadership and network building. The Foundation was established in 1940 by John R. Oishei, founder of Trico Products Corporation.

About The Peter and Elizabeth C. Tower Foundation

The Peter and Elizabeth C. Tower Foundation supports community programming that results in children, adolescents, and young adults affected by substance abuse, learning disabilities, mental illness, and intellectual disabilities achieving their full potential. The Foundation is dedicated to societal impact through healthy communities and capacity building.

About Independent Health Foundation

Established in 1992, the Independent Health Foundation works to improve the health and well-being of Western New York residents through awareness, prevention and education programs focused on community health priorities.

About The Primary Connection

The Primary Connection is a physician-led initiative that takes a coordinated approach to enhancing quality, access and affordability across the entire health care continuum. The initiative includes 30 practices, representing more than 190 high performing physicians who treat approximately 93,000 Independent Health members across Western New York.