Psychology Essential to the PCMH Model

Patient-centered medical homes (PCHMs) have much to gain by including psychologists in their teams of health care providers, according to a special section in the January issue of American Psychologist. The experience and expertise psychologists offer in behavioral health, the contributors pointed out, could advance PCHMs in their triple-aim mission of improving outcomes, decreasing costs, and enhancing the patient experience.

“A prime reason for integrating behavioral health into patient-centered medical homes is that behavioral health problems are very common in medical patients and frequently complicate care delivery and effectiveness,” explained contributor Nadine J Kaslow, PhD, of Emory University. 

“Up to 30% of primary care patients meet diagnostic criteria for behavioral health problems, including anxiety, mood, and substance use disorders. The costs of managing chronic disease increase markedly when co-occurring behavioral health conditions exist. Largely preventable and modifiable health behaviors, such as poor diet, lack of exercise, and tobacco and other substance use, contribute to nearly half of all premature deaths.”

__________________________________________________________________________________________________________
RELATED CONTENT
U.S. House Panel to take up Bill to Spur Generic Drug Development
California Lawmaker Introduces Bill To Ban Prescription Drug Coupons
__________________________________________________________________________________________________________

The January issue included five special-section articles promoting a place for psychologists in PCMHs as well as proof of their value in bettering patient outcomes. Benefits of on-site psychologists in PCMHs, contributors said, include improved attendance at appointments, increased patient adherence to care recommendations, increased patient engagement in health promotion activities, and better communication and care planning.

“Psychology must embrace its rightful place as a health profession in the PCMH model, which prioritizes the integration of behavioral and physical health care,” said Anne E Kazak, PhD, codirector of the Center for Healthcare Delivery Science at Nemours Children’s Health System.

The issue also highlighted current challenges impeding the widespread implementation of PCMHs as well as efforts to include psychologists in them—specifically, payment models. One article pointed out that medical and behavioral health services are historically fragmented and paid through two distinct channels, in which providers are paid for specific services during separate visits. Furthermore, the policies of some states even limit billing for medical and behavioral health services on the same day, according to the publication.

“To fully transform the US health care system, payment structures will need to change to focus on patient outcomes, rather than fee for service,” Dr Kazak said.—Jolynn Tumolo