- The integration of behavioral health services into patients’ regular primary care source can help accountable care organizations (ACOs) improve the efficiency of their delivery systems, suggested a new study published in Health Affairs.
- The UCLA researchers demonstrated such a move is feasible for ACOs, despite the perceived challenges, through 32 months of findings from a program they created called Behavioral Health Associates (BHA), which operates as part of UCLA Health.
- The system's BHA patients underwent a 13% reduction in their ED use, confirming the program indeed reached higher-utilizing patients, the authors found.
The study suggested BHA makes an appropriate model for other ACOs interested in integrating behavioral healthcare into their regular practice, with arguments for the increased reach of behavioral healthcare, details on how they did it, and on the projected sustainability of the progam.
As for expanding reach, the authors noted, at the time of BHA’s creation in late 2012, 21% of UCLA Health’s primary care population had been diagnosed with a behavioral health disease, though internal behavioral health providers were only treating 4% and the system didn't know whether the others were receiving outside treatment. Since then, BHA providers have treated 13% of the behavioral health population, more than tripling the system's number of patients served.
They accomplished it through numerous innovations, the researchers wrote, including adapting the use of their enterprise EMR for behavioral health referrals and documentation, registering BHA providers with insurers' mental health carve-out products, and embedding BHA providers into the system's primary care practices.
The researchers reported BHA has gone in three years from serving as a pilot program to a "sustainable service" surviving partly on revenue from reimbursements and most importantly on investments from UCLA Health. "These investments are made anticipating future shared savings in ACO contracts with the Centers for Medicare and Medicaid Services and other commercial payers," they stated. "With costs stabilizing as the program matures, we project that BHA revenue and attributed shared savings will cover the majority to nearly all of the program’s costs in coming years."