A major new study shows that delivering integrated mental and physical healthcare in team-based primary care settings at Intermountain Healthcare results in better clinical outcomes for patients, lower rates of healthcare utilization, and lower costs.
The study is published in the August 23/30 issue of the Journal of the American Medical Association . It was accompanied by an editorial in JAMA that heralded the benefits of integrated mental health care.
The 10-year study -- which is one of the largest studies of its kind -- shows the benefits of care provided by team-based providers in an integrated delivery system.
The study, which was conducted by Intermountain Healthcare researchers, measured 113,452 adult patients who received care from 2003 through 2013 in 113 primary care practices at Intermountain, including 27 team-based medical practices and 75 traditional practices.
Researchers found the following:
Patients in team-based medical practices also used fewer healthcare services and had lower total costs, according to the study.
Data showed that per 100 person years:
"For patients, the bottom line of the study is that getting care in a team-based setting where medical providers work hand-in-hand with mental health professionals results in higher screening rates, more proactive treatment, and better clinical outcomes for complex chronic disease," says Intermountain Healthcare scientist Brenda Reiss-Brennan, PhD, APRN, one of the study's authors. "Team-based care means providers work together to care for all chronic conditions, mental and physical. At Intermountain, 80 percent of mental health services are provided by primary care physicians, and when they're supported by an integrated team, both they and their patients benefit."
Intermountain's mental health integration model helps primary care and mental health providers collaborate to meet a patient's physical and mental health needs during each patient visit. They do that by focusing on prevention and early diagnosis, integrating care processes, enhancing information systems and reporting methods, and partnering with community resources. Intermountain has embedded mental health screening and treatment within primary care physicians' offices since 2000.
"Team-based care is just that, a team of healthcare providers from diverse disciplines -- physicians, advanced practice clinicians, nurses, mental health providers, and other staff members -- who work together with patients, families and communities to provide coordinated healthcare services," says Dr. Reiss-Brennan. "The team works collaboratively with patients to set and accomplish shared goals for improving patient outcomes."
Before the study, limited evidence was available to support the effectiveness of a care model that integrated mental health providers with primary care teams.
"The study reinforces the value of coordinated team relationships within a delivery system and the importance of integrating physical and mental health care," Dr. Reiss-Brennan says. "The study provides further evidence -- from a mental health perspective -- of Intermountain Healthcare's hypothesis that better care costs less."
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Senior author of the study is Brent James, MD, MStat, Intermountain's Chief Quality Officer and Executive Director of the Intermountain Institute for Healthcare Delivery Research. Other members of the research team included Kimberly Brunisholz, PhD; Carter Dredge, MHA; Pascal Briot, MBA; Kyle Grazier, PhD; Adam Wilcox, PhD; and Lucy Savitz, PhD.
JAMA