Population health: Better achieved through mental health integration, team-based care


By Scott Hammer

One in five adults in the U.S., and nearly 43 million people, experience mental illness during a given year. The cost associated to lost productivity in America for mental illness is $193 billion annually, according to the National Alliance on Mental Illness.

The majority of Americans suffering from mental illness and substance abuse disorders seek treatment in primary care facilities.

Integrating mental and physical healthcare is imperative to delivering whole-person care and helping patients live the healthiest lives possible. Properly diagnosing and treating mental disorders in primary care through an effective integrated care team is vital to the delivery of high quality care and achieving population health.

New Model in Utah
Intermountain Healthcare, a Utah-based, not-for-profit system of 22 hospitals, aims to deliver the highest quality of care at the lowest possible cost to patients through the delivery of Mental Health Integration (MHI) and Team-Based Care (TBC).

The TBC model provides a standardized clinical and operational care process that engages patients and families in primary care and incorporates mental health resources and supports.

In 2000, Intermountain embedded mental health screening and treatment within its primary care physician offices, investing in mental health integration. Today, it continues to utilize this approach to help patients with mental illness and to properly manage and treat their conditions.

Is it Effective?

In 2016, a 10-year Intermountain healthcare study in JAMA called “Association of Integrated Team-Based Care with Healthcare Quality, Utilization, and Cost” identified the effectiveness of integrating mental and physical health.

This landmark study demonstrated that integrating mental health in primary care by utilizing the Team-Based Care model produced dramatically better patient outcomes, more appropriate utilization of healthcare services and lower costs.

The study results showed:

  • A higher rate of patients screened for depression—a 22 percent increase.
  • A lower rate of emergency room visits—a reduction of 23 percent.
  • A lower rate of hospital admissions—a reduction of 10.6 percent.
  • Better patient care through improved care management—primary care physician encounters reduced by seven percent.
  • Lower payments to providers—$3,400 for patients in team-based practices versus $3,515 for patients in traditional practices for a savings of 3.3 percent.

For patients, the bottom line is that getting care in a Team-Based Care setting where medical providers work together with mental health providers, results in higher screening rates, more proactive treatment and better clinical outcomes for complex chronic disease.

Getting care in a Team-Based Care setting where medical providers work together with mental health providers, results in higher screening rates, more proactive treatment and better clinical outcomes for complex chronic disease. 

TBC has shown to be successful with MHI, and shows potential to be scaled and extended to many disease states, conditions and patient demographics.

Within Intermountain, this team structure has provided the foundation for Personalized Primary Care (PPC) and has standardized the TBC strategy for population health management.

While this approach requires sustained investment in leadership, clinical and analytic workforce, robust information systems, and quality incentives, the savings towards healthcare providers exceeds the cost and is sustainable.

In a value-based world, TBC and MHI will be critical components of population health. The elements of Team-Based Care will allow for organizations to realize the benefits of population health, increasing savings, and providing whole-person, high quality of care for patients.

KHC 4th Annual Conference Preview and Guest Blog. Scott Hammer is project manager of Strategy & Operations at Mental Health Integration (MHI), Intermountain Healthcare. If you want to learn more about Intermountain’s mental health integration work, be sure to REGISTER for the KHC’s annual conference on March 13-14, 2018 to hear from Brenda Reiss-Brennan, PhD, Mental Health Integration Director, Intermountain Healthcare.