Behavioral Health Integration in Primary Care Pediatrics: A Pilot Utilizing a Collaborative Care Model


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Many U.S. children suffer from behavioral health disorders such as attention deficit hyperactivity disorder (ADHD), behavior/conduct disorders, anxiety and depression. Nearly 50% of youth do not receive the treatment or counseling from a mental health professional that is indicated for their condition which may lead to significant morbidity. The literature supports the value of integrating behavior health into primary care pediatrics using a collaborative care model. This project was designed to pilot this model in a single primary care pediatric practice location within a multi-specialty, ambulatory medical group. In preparation for the pilot, an analysis of visit data for the pilot site revealed that 17.2% of children had been seen for one or more behavioral health conditions in a 12-month period – findings that very consistent with state and national reports. Pro formas revealed that a behavioral health care manager with a modest patient panel (i.e., 46-53 children) billing monthly for time-based services using Psychiatric Collaborative Care Services CPT codes would provide a financially profitable service. As part of the project, a behavioral health care manager position was also created, and a psychiatric consultant was identified. The EHR was leveraged to develop communication, documentation, and billing tools and to begin the build of a patient registry. The project was interrupted in late February 2020 because the organization’s resources were redirected to the COVID-19 pandemic response. It is anticipated that the project will resume sometime later in 2020 at which point the final preparations will be completed before undertaking the actual pilot. Evaluation will occur over the subsequent six months. The ultimate goal is to roll out this model in 2021 across the remaining ten of the organization’s primary care pediatric practice locations.



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