The healthcare environment is changing, and doing so rapidly. Outpatient practices are interfacing more with large healthcare entities, and are seeing a wider mix of third party payers associated with the Affordable Care Act. It is well established that behavioral health will play an important role in the collaborative work of Accountable Care Organizations, but few models exist to demonstrate exactly how most will do so. With all of the unknowns, here are a few great ideas to begin to prepare yourself for any changes ahead.
Great Idea #1: Stronger Collaboration With Primary Care Can Only Help
As healthcare begins to gravitate towards the “Patient Centered Medical Home” model, it is clear that primary care professionals will be in the position of caretaker of the household. It has been clear in the literature for quite some time that the majority of people with mental health concerns will seek out help from their primary care doctor rather than seek out mental health services directly. It is also a recurrent finding that the majority of people referred to mental health by their PCP will not follow through, unless there is close coordination between the medical provider and the behavioral health provider. Finding ways to communicate about referrals, especially those that don’t call is an important component of helping people access mental health services. Many people do not know what to expect, or have misconceptions about what goes on at a counselors office. Communicating ahead of the intake starts the therapeutic relationship off on a good note, and helps the PCP know the difference between a referral that didn’t call, and you simply not updating him or her on the outcome. EarlyByrd is one way to encourage primary care professionals to obtain permission for you to call the patient, and to indicate to you that you should do so. Handling referrals in this manner substantially boosts the follow-through rate, and increases overall collaborative care.
Great Idea #2: Continuously Evaluate the Efficacy of Your Intake Systems
Do you know how many physician referrals come in to your practice? Do you know how many don’t follow through? How? In organized healthcare systems, a referral includes information to the patient on where to go for the recommended services, and notification to the specialist on what is being requested. Why do we feel that a business card is sufficient in mental health? Using a secure, easy to access referral system helps you be aware of referrals, regardless of if they contact you. Notifying the referring professional of completed consults, as well as those that did not occur allows the PCP to have a follow-up conversation with the patient and continue to work on solving the referral issue. In some cases, the patient may welcome a call from you. In other cases, the PCP may place a call during the patient’s office visit. Co-located providers have the luxury of conducting these “warm-handoffs” in person, which is extremely effective. Those of us in outpatient, separately located practices can do a great job of facilitating referrals, but we must be more accessible, and more involved in the process than has typically been the case. EarlyByrd provides a suite of tools for this exact purpose, and can give several easy ways to allow referrals to be submitted to you without a shared EMR system in place.
Great Idea #3: Be Involved, and Be Visible
If you are a solo provider, or work in an independent private practice, you may feel somewhat disconnected from the developments going on around you. Across the country, groups of providers are discussing ways to interface with organized healthcare. Whether this is through an independent practice association, or some other mechanism, being professionally involved in your professional community can keep you aware of what is being discussed in your “neighborhood”. Be involved in your state professional association and attend regional conventions and/or healthcare reform workshops near you. Make sure local hospitals or ACOs have a care coordinator that knows who you are and what you do. As part of the referral solutions provided through EarlyByrd, our behavioral health provider directory was designed to give immediate access to healthcare organizations to mental health providers nearby. Having an active profile in this directory gives you an inexpensive way to maintain one avenue of visibility 24/7.
