Delaware Public Media

First State seeks to bring behavioral health treatment to primary care.

Dec 17, 2017

As the cost of healthcare in Delaware outpaces the state’s economic growth, officials are searching for ways to make providing healthcare more efficient and effective.

That plan includes continuing work to integrate behavioral health treatment with primary care settings.               

The Delaware Center for Health Innovation has been working to create closer cooperation between behavioral health and primary care clinicians in the state for a few years.

Embedding behavioral health professionals in a primary care setting can help doctors provide more effective treatment to patients with behavior or substance abuse disorders. It can also drive down the cost. Nemours, Christiana Care and some Federally Qualified Healthcare Centers in the state are already using successful integration models.

Delaware Healthcare Commission Executive Director Dr. Ann Kempski says one integration model might include embedding a social worker into a primary care staff, but she says it is costly to do so.

“I don’t think Delaware is unique, but Delaware has smaller primary care practices, and a small primary care practice often can’t financially support a workforce that can, for instance, support a social worker,” said Kempski.

Kempski notes another challenge to integrating behavioral health with primary care is the payment models are not the same.

But Mid-Atlantic Behavioral Health CEO Dr. Traci Bolander notes integration can also promote healthy behavior in patients with other high dollar chronic disorders like diabetes.

“What behavioral health consultants are really skilled at—in particular, psychologists—is behavior change," said Dr. Bolander. "Getting a diabetic to follow a diet, or getting somebody who is smoking to stop smoking—those are behavior changes.”

The state contracted the public health consulting group Health Management Associates in October to help oversee this process and other efforts to reign in Delaware’s healthcare cost.   That group is visiting clinics throughout the state on a listening tour.