One of the questions for specialty and primary care provider organization executive teams is how to participate in integrated systems of care. There are a variety of models—and no right answer. Some specialty provider organizations have added primary care services (see The Behaviorally-Led Primary Care Practice: Addressing Six Key Elements For Successful Integration), and some primary care organizations have added behavioral health clinicians to their clinical team. This integrated service delivery approach is the apparent future path of large insurers, such as CVS/Aenta acquiring Oak Street Health and Amazon’s acquisition of OneMedical.

There are also co-location models—with separate organizations sharing space and providing consumers with a one-stop-shop (see Choosing An Integration Model Is Not Once & Done). In addition, there is virtual integration using health insurer care coordination platforms (see Using Technologies & Analytics To Improve Behavioral Health Access & Outcomes: Lucet’s Approach To Integrated Care Management). And provider organizations can also participate in integrated systems of care (see WakeMed’s Path To Value & Whole Person Care: The Development Of The WakeMed Behavioral Health Network).

A recent survey provided an interesting snapshot of the market landscape. 51% of behavioral health provider organizations reported having an integration strategy in place. For primary care organizations, this is 29%. These were the results of a survey conducted by NextGen Healthcare and OPEN MINDS and published in a new white paper, The State Of Whole-Person Care: A National Survey Of The State Of Integration In The Behavioral Health & Intellectual/Developmental Disabilities.

As the white paper points out, combining data from disparate sources including physical health, behavioral health, and social determinants of health (SDOH) continues to be a challenge for providers. In the survey, 53% of respondents indicated that they are using existing operational technology to collect all the information they need. About 20% reported that they are using two separate systems, such as one for health records and another for collecting information such as SDOH referrals. Meanwhile 18% said they are using more than two systems. Lastly, 8% stated their technology use does not fit into any of those categories with one respondent describing they have had to move back to using paper models due to various issues with technology integration and implementation.

When asked about their upcoming technology functionality needs, coding topped the list. 65% of executives reporting needed better functionality for coding—particularly ICD-10 Z code for mental health. The next functionality lift has to do with incorporating consumer screening and assessment information into the EHR—26% reported needing functionality for SDOH screening questions and 17% for consumer assessments. 22% were looking for integration of consumer survey data into the EHR. And, 19% were looking for functionality to support SDOH initiatives.

The focus on social determinants and consumer input is not surprising with the shift to a whole person care models—and the increased integration of performance-based measures in reimbursement. For success, provider organizations need to ‘manage’ medical, behavioral, and social services—even if they are not providing those services. And, the most common performance metrics—ER use, readmissions, HEDIS, and CMS Stars—all lean heavily on consumer experience and consumer engagement.

The push to integrated care models and whole person care approaches to service delivery is continuing. The challenge is that every payer—and every health plan—has a slightly different model for making integration happen. In the year ahead, we have planned a number of sessions focused on the payer and health plan perspectives on “best practice” integration strategies:

• Best Practice Models For Financial Management Of Performance-Based Contracts
• Kaiser’s Human Centered Approach To Strategic Care Innovation
• Creating A Value-Based Center Of Excellence Proposal For Health Plans
• Creating A Framework For Sustainability — The Acenda Integrated Health Case Study
• Managed Care Models For I/DD Services
• Transformation Showcase: Making Digital Transformation Work
• Beyond The Patient Portal – Consumer Technologies To Enhance Care Delivery
• Becoming An Efficient Organization – The Metrics Of Financial Strength & Streamlining Your Service Portfolio
• Turning Artificial Intelligence Into Actionable Intelligence
• The Complexities Of Managing Whole Person Care: What It Looks Like & Why It Is Important?

For even more on integration, mark your calendar for June 15 in New Orleans at The 2023 OPEN MINDS Strategy & Innovation Institute and for the session, Integrating Digital Tools Into Service Delivery, featuring Stephen Smith, Cofounder and Chief Executive Officer for NOCD.