Collaboration between NCQA Patient-Centered Medical Homes and specialty behavioral health and medical services

There is increased recognition that more mental health concerns are seen in primary care than any other healthcare setting. The Patient-Centered Medical Home (PCMH) is a significant redesign of primary care, and many of the principles of the PCMH appeal to the usage of a whole person mind-and-body treatment approach that is responsive to all the patient's needs. This study examined the level of collaboration between National Committee for Quality Assurance (NCQA)-recognized PCMH primary care practices and outpatient specialty behavioral health services (when compared to other medically oriented specialties). In 2010, a 20-item survey was sent to 238 NCQA PCMHs to learn what they were doing to address behavioral health needs in primary care. A sub-dataset from the survey was analyzed in order to look specifically at referrals, communication, and scheduling-support processes. These data were compared with how the practice responded to similar questions about endocrinology and cardiology. Results from the participating 123 practices revealed that very few practices address behavioral health conditions as they would other medical conditions. This is evidenced by the lack of routinized processes to assist with referrals, communication, and scheduling to outpatient behavioral health services. There appears to be significant opportunity to improve how behavioral health is addressed in the patient-centered medical home.