UCLA Health program improves access and medical outcomes for people

A collaborative care system developed at UCLA Health benefits patients and reduces costs by merging two areas of health care that often have often not been well-integrated: primary care and mental health services.

Known as Behavioral Health Associates, the unique approach by UCLA has tripled the number of people receiving the behavioral health care they need, cut the number of visits to the emergency room, and provided solutions to long-standing administrative problems.

More than 26 percent of adults have a diagnosable health disorder in any given year, and 20 percent of children suffer from mental illness. People with behavioral health disorders typically use the health care system more than those with medical issues alone and tend to have worse health outcomes than people who just have medical care needs.

Studies have shown that people with behavioral health problems, such as depression, are less likely to adhere to the medical care recommendation they receive from health professionals. This is due, in large part, to the fact that medical and behavioral care are often not well-integrated.

“Our goal was to create a new approach to treating primary care patients with behavioral health problems to improve their overall care while also addressing long-standing administrative barriers to collaborative care,” said Dr. Mark Grossman, clinical professor in the departments of medicine and pediatrics at the David Geffen School of Medicine at UCLA.

Grossman is a co-author of the study, which was published Aug. 8 in the journal Heath Affairs.

Although integrating primary health care with mental health care services is an important goal of accountable care organizations, the process poses significant challenges, such as recruiting mental health care providers, receiving reimbursement for that care, and determining how best to add new services to an existing infrastructure.

In 2012, UCLA Health developed the Behavioral Health Associates program. Collaborative care programs similar to BHA exist, but they rely on outside support such as multi-payer networks and partnerships with state agencies. BHA incorporates behavioral health services into UCLA Health, an integrated academic medical center. The UCLA model, which serves a primary care population of 250,000 people, delivers a full range of primary health care and behavioral health care within a single health care system.

Over a three-year period, the BHA program more than tripled the number of patients who received behavioral health services through the UCLA Health system and helped lead to a 13 percent reduction in emergency department usage.

“The demand has been robust and the result is a significant increase in services we provide coupled with equally significant savings to UCLA,” said Dr. Samuel Skootsky, professor in the department of medicine and a study co-author. “These results show that a single delivery system within the accountable care organization framework benefits patients and lowers costs and offers a workable solution to the problems presented by segmented care.”

Other authors of the study were Dr. Jessica Jeffrey, clinical assistant professor in the department of psychiatry; Dr. Thomas Strouse, professor of psychiatry; and Dr. Michael Gitlin, professor of psychiatry.

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