Integrating Behavioral Health into The Medical Home: A Rapid Implementation Guide

Table of Contents

SECTION I: GETTING STARTED

Introduction
Chapter 1: Why Integrate Behavioral Health?
Chapter 2: Shared Interprofessional Skills: Language and Collaboration Optimize Operations
Chapter 3: What Are Your Needs?
Chapter 4: A Menu of Integrated Behavioral Health Options

SECTION II: BUSINESS DEVELOPMENT, POLICY, AND OPERATIONS

Chapter 5: Policy
Chapter 6: Business Development
Chapter 7: Calculating Value and Revenue Cycles
Chapter 8: Measuring Your Program’s Impact
Chapter 9: Hiring
Chapter 10: Training
Chapter 11: Facilitating the Transition Process to Integrated Care

SECTION III: CASE STUDIES, PROFILES, AND EXEMPLARS

Chapter 12: System Initiatives
IMPACT
Colorado Access
Aetna
Cherokee Health Systems
Intermountain Health
Edmonton Southside Primary Care Network
The Piedmont Health Group

GLOSSARY

About the Authors

Kent A. Corso, PsyD, BCBA-D, is a licensed clinical health psychologist and board certified behavior analyst. As a veteran of Operation Enduring Freedom, he is a former Air Force officer with 15 years of teaching and training experience in university and medical settings. Dr. Corso currently holds an adjunct assistant professor position in the Department of Family Medicine at the Uniformed Services University of Health Sciences. He leads the primary care behavioral health program for the Military Health System in the Washington, D.C., region, which enrolls more than 137,000 beneficiaries. Dr. Corso is the president of NCR Behavioral Health, a consultation group that assists diverse healthcare delivery systems in the United States and abroad in the development of profitable, cost saving, quality-enhancing integrated behavioral health programs by leveraging population health principles, cutting-edge practice models, sound business strategies, and high-quality training.


Christopher L. Hunter, PhD, ABPP, graduated from the University of Memphis specializing in behavioral medicine. He is board certified in clinical health psychology and works for the Defense Health Agency as the Department of Defense (DoD) program manager for behavioral health in primary care. As the DoD lead for the last seven years, he has worked to develop policy, secure funding, and oversee the rollout of primary care behavioral health services for 3.3 million Military Health System enrollees. He is a previous chair for the Society of Behavioral Medicine’s integrated primary care special interest group and is a Collaborative Family Health Care Association board member. He has extensive experience developing integrated primary care behavioral health services as well as training individuals to work in primary care settings to treat common mental health conditions (e.g., depression), health behavior problems (e.g., tobacco use, obesity) and chronic medical conditions (e.g., diabetes, chronic pain). He is also the lead author on the 2009 book, Integrated Behavioral Health in Primary Care: Step-by-Step Guidance for Assessment and Intervention and a co-editor of the 2014 Handbook of Clinical Psychology in Medical Settings: Evidence-based Assessment and Intervention


Owen Dahl, MBA, FACHE, CHBC, LSSMBB, has been active in healthcare management for almost 50 years. He received his bachelor’s degree from Concordia College, Moorhead, Minnesota, where he was a member of the first graduating class in the hospital administration program. He received his master’s degree from the University of Northern Colorado and has done additional study at NOVA Southeastern in Ft. Lauderdale, Florida. He spent more than a decade as a hospital administrator in various facilities in South Dakota. He also served in the United States Air Force and the Army National Guard. His move to New Orleans in 1983 brought a major career change. He started a practice management and billing company, which grew to manage 65 physicians in 11 different practices. In 1993, he advanced to Fellow in the American College of Health Care Executives with a paper on Total Quality Management and its application to the medical practice. Hurricane Katrina brought about another change that led to his current efforts as an author, consultant, public speaker, and adjunct professor. He has worked with Loyola University in New Orleans, the University of New Orleans, the Louisiana State University School of Medicine, and the University of Houston–Clear Lake on physician practice management programs. This change came about due to a long-standing passion to seek to improve the delivery of patient care through training and education. He developed the first certification program for the Professional Association of Health Care Office Managers (PAHCOM) and the certification program for the National Society of Certified Health Care Business Consultants (NSCHBC). Currently an independent consultant with an affiliation with the Medical Group Management Association (MGMA), he has developed training programs in various “belt” levels in Lean Six Sigma and the application to today’s medical practice. Mr. Dahl is married with three children and two grandchildren. He currently resides in The Woodlands, Texas.


Dr. Gene “Rusty” Kallenberg has been the chief of the Department of Family Medicine and Public Health and vice chair of the Department of Family and Preventive Medicine at the University of California, San Diego (UCSD) since 2001. Previously he was the chief of family medicine and assistant dean for curricular projects at George Washington University (1982–2001). He has been a member of the Collaborative Family Healthcare Association (CFHA) for the past 18 years and is the current president, having served on the board for the past three years and as treasurer. Dr. Kallenberg has overseen the development of integrated behavioral healthcare programs within the PCMH-certified family x Integrating Behavioral Health into the Medical Home: A Rapid Implementation Guide medicine practices of his Division of Family Medicine (DFM) since 2002. With over 23 part-time trainee, intern, and licensed MFTs and psychologists and psychiatrists, the DFM Collaborative Care Team serves several thousand patients each year. Dr. Kallenberg also is the director of the new UCSD Center for Integrative Medicine, which opened in 2010. Dr. Kallenberg’s interests include new models of primary care, mental health/primary care collaboration, integrative medicine and undergraduate/graduate medical education, and competency assessment in the content areas of communication skills, doctor-patient-family relationships, health systems, and professionalism.


Lesley Manson, PsyD, has spent over a decade providing direct service. Her dedication to behavioral health and integrated care models led her to directing behavioral health programs, providing continuing education to healthcare providers, and developing workshops and trainings for behavioral health and primary care providers to be successful and integral members of healthcare teams. She has advanced experience in continuous quality improvement, behavior change, and standardization and outcome measurement for behavioral health programs integrated into primary care. Dr. Manson has spearheaded multidisciplinary teams for primary care process improvement and population-specific quality improvement and standardization, which has led to improved healthcare outcomes, enhanced quality assurance, increased compliance and patient engagement, and reduced healthcare costs. She was an integral member of teams for the development of electronic medical health records with integrated shared behavioral health focusing on standardization, best practices, and evidence-based techniques. Her history as a healthcare executive has led her to developing national presentations and publications on integration with both clinical and management focus and providing consultation and training for primary care and medical/behavioral organizations in developing and auditing for integrated care sustainability. Historically, Dr. Manson has been an active member of her local and national professional primary care and behavioral health organizations, serving on numerous boards and receiving recognition. She is a former president of the North Coast Association of Mental Health Professionals in California and was honored with certificate training from the Johnson and Johnson UCLA Health Care Executive Program. She is also a master trainer for the Institute for Health Care Communication and conducts workshops in the area of clinician-patient interaction and communication to meet the Triple Aim. Dr. Manson serves as a clinical assistant professor and director of integrated training initiatives at Arizona State University’s Doctor of Behavioral Health Program.