MEDFORD, Ore.—It could be a patient with diabetes who needs help with depression, or a child who’s adjusting to his parents’ divorce. But about 70 percent of all primary care visits also have a psychological component that relates to physical health, says Mike Miller, a licensed clinical social worker who also holds a doctorate in psychoanalysis.
On the premise that all patients should have the opportunity to benefit from behavioral health services, and knowing how important those services are to a person’s overall health, Jackson Care Connect is helping primary care clinics all across Jackson County integrate behavioral health into their practices.
Jackson Care Connect is a nonprofit Coordinated Care Organization (CCO) providing care for Oregon Health Plan (Medicaid) members in Jackson County. Laura Heesacker, Behavioral Health Innovation Specialist at Jackson Care Connect, says while behavioral health integration is not a new model, it has picked up speed in recent years. Now, several clinics across southern Oregon have integrated the model, with positive results for both patients and providers.
Jackson Care Connect provides financial and technical support to help clinics make the transition. Since Jackson Care Connect began providing these funds, the number of behavioral health consultants working in primary care settings in Jackson County has increased by 50 percent.
Local clinics that are participating in Jackson Care Connect’s program include Asante Physician Partners, Providence Medical Group, La Clinica, Valley Family Practice, Southern Oregon Pediatrics and Rogue Community Health.
In 2016, Jackson Care Connect provided Valley Family Practice with a one-time $100,000 capacity building grant to begin their program. That allowed the clinic to hire Dr. Miller, where he works closely with five primary care providers.
Miller says being located in the same facility as the primary care clinicians means a patient is more likely to get the care they need, and in a timely matter. When patients are referred to an outside behavioral health specialist, he says, they often don’t follow through on that referral. But in an integrated model, clinicians can give the patient a “warm handoff.”
“They can literally walk across the hall and introduce the patient to me,” Miller says.
As a result, of this easy access, Miller says, “We’re catching people early with their trauma, with Post-Traumatic Stress Disorder, with depression, etc.”
Heesacker says the integrated model of behavioral health is most successful when the provider has a high level of expertise. “They must have an understanding of what’s happening from a psychosocial view, and look for underlying issues,” she says.
Miller’s experience in a variety of specialties—including geriatrics, hospice, drug/alcohol addiction and neuroscience—serves him well in his new role. He also worked for years at the Veterans Administration and in private practice as a licensed clinical social worker. Because of this breadth of experience, he can address a wide variety of patient needs, from individual counseling to addiction treatment plans, memory screens and more.
Miller says the other key to success is the mutual trust between him and his colleagues at Valley Family Practice. He says, “patients’ needs are being met at a higher level clinically than they were before.”
Southern Oregon Pediatrics has also added integrated behavioral health into its practice. Having a psychologist in the clinic allows physicians to do more preventive care, instead of waiting for problems like depression or eating disorders to emerge.
Dr. Matt Hough, Jackson Care Connect medical director and a physician at Southern Oregon Pediatrics, says with this shift, both patients and his fellow physicians have experienced improved care. He says “it’s impossible to live without that position at the practice now.”
As primary care clinics bring a behavioral specialist into their setting, there is a learning curve regarding fees, insurance billing and other system details. Jackson Care Connect will continue to provide support and assistance to clinics as they integrate behavioral health into their patients’ primary care.
“This model works,” Miller says. “I have done traditional mental health models for years and this is about relationships and it’s about connecting with people. This stuff works.”