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Monday, April 15, 2019 - Building a Better Bridge
Primary care physicians (PCPs) are often among the first to spot behavioral problems in patients. To help make the process of finding the right behavioral health professional more seamless, Horizon BCBSNJ has teamed up with Quartet Health. Through Quartet, Horizon provides an online platform that primary care doctors can use to connect their patients with mental health providers in the Horizon network.
“There is a huge fragmentation between physical and behavioral health,” said Susanne Kunis, director of behavioral health solutions for Horizon BCBSNJ. “By integrating everything you make it so much easier for people to get the care that that they need.”
Doing a better job of managing care and getting people what they need when they need it and where they need it, asserted Kunis, translates into fewer emergency room visits and hospitalizations, better drug utilization and lower costs and lower premiums.
“That has been such a huge hole in behavioral health. The biggest complaint from primary care physicians is that they send their patients off to a therapist and they never hear back. They don’t know what’s going on or they don’t know if the patient is taking medications,” Kunis explained.
Horizon introduced Quartet to primary care practices — that is, value based providers and the major health systems who own primary care practices — in five counties and to key value-based provider organizations and strategic alliance health system partners in other areas of the state.
Quartet brings in the mental health access resources, support and care navigation, all the different stakeholders in a particular health care setting, said Chief Medical Officer Dr. David Lim.
“When a PCP recognizes a mental health condition that needs to be addressed they have the ability with Quartet to tell the patient that they work with a company that knows the mental health providers in the area,” said Lim.
The primary care physician provides basic information about the patient via a secure portal and Quartet links the patient with a mental health professional and reports the results of the visit to the PCP.
Quartet then works with Horizon to identify patients with signs of undiagnosed behavioral health conditions and alerts the patient’s PCP when an indicator is found.
With this data, a physician can have a discussion with the patient to see if additional care is warranted and if so, the patient is referred to an appropriate behavioral health specialist.
‘Surrounding the patient’
Lim said this process takes the burden off the patient and it gives the primary care provider the ability to monitor what is going on regarding the patient’s progress and treatment plan.
“We have teams of people surrounding the patient, the PCP, the medical assistant in the office, the mental health provider and care navigator. So now there is very good tight virtual team surrounding the patient,” said Lim.
Dr. Christopher Trotz, executive medical director at Inspira Health, said that between 20 percent and 40 percent of patients seeking care by a primary care provider have a diagnosable mental illness, but 60 percent of these patients do not receive appropriate care. Several barriers are responsible for this dynamic including limited access and stigma, among other factors.
“Quartet is an innovative technology that has provided primary care providers the ability to transition patients requiring behavioral health interventions beyond the scope of the primary care practice,” Trotz said. “Through Quartet, we have been able to significantly increase the percentage of patients accessing behavioral health and reduce the time it takes to access this care.”
Trotz added that the stigma associated with behavioral health has historically been a major barrier to patients accessing behavioral health intervention. Quartet, he said, has provided a platform that allows primary care providers to transition patients with behavioral health needs to mental health professionals in a confidential and efficient manner.
“At the visit with a primary care provider, patients can now be directly connected via Quartet with a behavioral health specialist for therapy or medication management,” he explained. “The process has been timely with most patients being linked to Quartet in 48 hours and to a mental health professional in three to seven days.”
Historically, Trotz said, this process could take several weeks or months in some cases. More important, he said the Quartet platform allows for communication between the primary care provider and all members of the behavioral health care team. In addition, there is an option for patients to communicate with a member of the quartet team to monitor their progress and compliance with new medication instructions.
Trotz said it is vital that a primary care doctor be kept in the loop regarding a patient’s mental health status.
“Non-compliance is a fairly common occurrence with the management of mental health conditions. The Quartet platform provides a forum for sharing clinical information about patients with mental health disorders between primary care providers and other members of the care team. This bi-directional flow of information in a secure and confidential manner has been a major satisfier for clinicians and patients.”
By: Anthony Vecchione
Physician Referral Line
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