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HLCCompendium
HLCCompendium
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NDHI<br />
NAT IONAL DIALOGUE FOR<br />
Healthcare Innovation<br />
Behavioral Health Integrated<br />
Care Model<br />
Organization Overview<br />
• Marshfield Clinic Health System is a not-for-profit<br />
healthcare system with over 50 care locations, an<br />
expansive medical group practice, an ambulatory<br />
footprint, and a health plan<br />
• The health system covers the entire spectrum of care<br />
from wellness to end of life care, with an emphasis<br />
on efficient and effective patient-centered care in<br />
both public and commercial markets<br />
Background<br />
Marshfield Clinic experienced difficulty in recruiting<br />
clinical psychiatrists, despite overwhelming demand<br />
for these services. In order to serve the unmet needs<br />
of patients and increase access to care, Marshfield<br />
Clinic developed the Behavioral Health Integrated<br />
Care Model. This care delivery model also improves<br />
the value of care delivered by encouraging appropriate<br />
patients to be managed by a PCP and Integrated<br />
Care Coordinator, rather than utilizing unnecessary<br />
high-cost services.<br />
The program is offered to adults, age 18 and older,<br />
with a psychiatric diagnosis or question of depression,<br />
anxiety, ADD/ADHD, OCD, PTSD, and other disorders.<br />
The program was piloted beginning in October 2013<br />
and went into full deployment to all Marshfield Clinic<br />
East District primary care in October 2015. During the<br />
most recent 10 months, the program has screened<br />
over 1400 patients. Of these, 819 are enrolled and<br />
being managed through the Integrated Care Model.<br />
Program Details<br />
• For patients who are enrolled in the program, care<br />
is delivered through a collaborative team that<br />
oversees the patient’s care:<br />
––<br />
Primary Care Provider (PCP)<br />
––<br />
Integrated Care Coordinator (ICC)<br />
––<br />
Consulting Psychiatrist<br />
• The Integrated Care Coordinator (ICC), who is<br />
usually an RN, serves as the primary manager of<br />
the patient’s care:<br />
––<br />
Meets with the patient to complete an evaluation<br />
of medical history and symptoms<br />
––<br />
Assesses and monitors symptoms through<br />
tracking tools<br />
––<br />
Acts as a point of contact for all referrals for<br />
Behavioral Health Integrated Care & Psychiatry<br />
• When primary care physicians (PCPs) need<br />
assistance in managing patients’ mental health<br />
diagnoses, the patient is enrolled in the Integrated<br />
Care Model program<br />
An Initiative of the<br />
73 |<br />
Behavioral Health Integrated Care Model
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