Behavioral health integration is not a new idea. It started to garner mainstream traction in the 1970s, and as we sit here in 2024, nobody disputes the idea that we should integrate mental and physical health. It is unquestionably the right thing for patient care, and for total cost of care.
The last fifty years have brought amazing ideas, pilots, and learnings — but as an industry, we have yet to drive widespread adoption and success. At Iris Telehealth, we think that is about to change. The data, care models, and technology have evolved to make driving scalable and sustainable clinical and financial outcomes possible.
Let’s talk about what we’ve learned as an industry, where the industry is going, and why the time is now to drive widespread adoption of behavioral health integration.
Why hasn’t Behavioral Health Integration lived up to the hype yet?
In entrepreneurship, there is a maxim that the success of any business comes down to 5% having the right strategy and 95% having great execution. With behavioral health integration (BHI), the strategy we all need to take to find success is no different. By integrating the right resources into a patient’s care team, we can drive better outcomes and better total cost of care.
However, the biggest challenge with the industry approaches to date is scalability. There are no doubt great experiences, data, and outcomes. But results have been difficult to scale across patients of higher acuities, within rural geographies, and with financials that incentivize their organizations to invest over the long haul.
From our conversations with customers, too many have given up, or have stopped scaling their programs because they run into operational or financial roadblocks that prevent them from achieving their ultimate mission.
So, how can we overcome this challenge to solve behavioral health integration?
There are a few key evolutions in the market that have changed the game: the ability to integrate virtual care locally, the ability to algorithmically identify the patients that need care the most, and the development of care models that are financially sustainable. Let’s talk about each.
Virtual care in behavioral health is a game changer. The unfortunate reality is that 70% of counties in our country do not have a licensed child psychiatrist and 60% do not have a licensed psychiatrist. Additionally, virtual care allows you to leverage resources across geographies to ensure resources are being used efficiently so that smaller populations can still receive great care. So, virtual care has to be part of the story. But, again, it comes down to the “how.”
The answer is dedicated virtual care teams with local integration. There must be trust between virtual and in-person teams with shared goals, technology platforms, and communication mechanisms.
The on-site teams must truly see the virtual providers as an extension of their teams – something that can only be established if the virtual providers know the local culture, are operating on the same technology platforms, communicate constantly, and have aligned goals.
The second critical ingredient is utilization of data to measure and drive success. Data has also unlocked our ability to determine who should receive care when. The reality is some patients are at higher risk of escalating than others, and the data exists within EMRs to intelligently prioritize who should get care first. This process could mean prioritizing the referral queue to ensure patients in highest need care first or it could mean proactively identifying patients that need care, even if they have not been referred. The data, algorithms, and technology are all there, we just have to do the work.
Finally, we have decades of learning around the optimal care model that we should apply going forward. Navigation assessments must be part of the story to ensure each patient is getting clinically appropriate care from a provider working top-of-license. We need to incorporate short-term care models as clinically appropriate. There must be a care team approach to ensure patients of all acuities can receive the best care for their situation. And, there must be collaboration with the broader team and community providers to ensure patients are receiving continuous, quality, whole-person care.
If we do all of these things, the financials follow – both on a fee-for-service basis and from a total cost of care perspective. We have proven that it is possible to deliver great clinical care while delivering a positive operating margin for our partner health systems.
So, what’s next for Behavioral Health Integration?
We cannot give up on the idea of behavioral health integration. If we take the learnings we’ve had as an industry over the last few decades and apply them, we can absolutely scale BHI across entire populations in a way that delivers sustainable financials and fantastic clinical outcomes — all while increasing patient and provider satisfaction.
We believe Bridge Care Services is the answer to Behavioral Health Integration.
Bridge Care Services leverages a cross-functional care team to ensure patients who need help first, get seen first. They’re able to get the appropriate care plan for their needs and are supported throughout their care journey.