Intermountain was chosen as a finalist from a highly competitive field based on their achievements in mental health integration. Approximately 43 million American adults (18 percent of the total adult population) suffer from mental illness. Starting in 2000, Intermountain embedded mental health screening and treatment into primary care and select specialty practices, utilizing a team-based approach to help patients and their families manage the complexity of both mental and physical health.
Impact of program, based on a retrospective longitudinal cohort study between 2003 and 2013 (data of 113,453 unique patients) comparing Team-Based Care to Traditional Practice Medicine:
- A dramatically higher rate of patients in team-based practices were screened for depression — which allowed clinicians to provide medical and behavioral interventions earlier — compared to patients in traditional practices. 46.1 percent of patients in team-based practices were diagnosed with active depression compared to 24.1 percent in traditional practices.
- 24.6 percent of patients in team-based practices adhered to diabetes care protocols, including regular blood glucose testing, compared to 19.5 percent in traditional practices — which demonstrated how well patients engaged with care teams in working together to manage their health.
- 48.4 percent of patients in team-based practices had a documented self-care plan to help them manage their health conditions, compared to 8.7 percent in traditional practices.
- 85.0 percent of patients in team-based practices had controlled high blood pressure, compared to 97.7 percent in traditional practices (although the care teams involved in the study didn’t focus on blood pressure like they did on depression and diabetes).
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:
- The rate of emergency room visits was 18.1 for patients in team-based practices versus 23.5 visits for patients in traditional practices, which is a reduction of 23.0 percent.
- The rate of hospital admissions was 9.5 for patients in team-based practices versus 10.6 in traditional practices, which is a reduction of 10.6 percent.
- The number of primary care physician encounters was 232.8 for patients in team-based practices versus 250.4 for patients in traditional practices, which is a reduction of 7.0 percent.
- Payments to providers were $3,400 for patients in team-based practices versus $3,515 for patients in traditional practices, which is a savings of 3.3 percent. The payments were less than the investment costs Intermountain incurred in creating the team-based practice model.
“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 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.”
The full study can be viewed online 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 healthcare.
The American Heart Association/American Stroke Association, and the California Maternal Quality Care Collaborative are the other finalists. The three finalists will present their programs at a special poster session at the 17th annual Population Health Colloquium in Philadelphia on March 27, 2017. The $100,000 Hearst Health Prize will be awarded the next morning.
For additional information about the Hearst Health Prize, please go to www.jefferson.edu/HearstHealthPrize or visit the Hearst Health booth #2531 at HIMSS17, February 20-22 in Orlando, Florida.