Integrated care can lower costs, reduce utilization rates

A recent study conducted by Intermountain Healthcare examined if treating both the mind and body yields better care and lowers cost.

With limited evidence available to support the concept that integration of mental health and primacy care leads to improved care, Intermountain conducted a large scale test to prove it. Comparing patients who received primary care at an integrated team-based care (TBC) practice and those receiving care at a traditional practice management (TPM) practice, the researchers examined patient outcomes, healthcare utilization and cost.

The study included 113,452 patients over the age of 18 who visited 27 TBC practices or 75 TPM practices between 2010 and 2013.

Results of the study included:

• 46.1 percent of patients who visited TBC facilities received a depression screening, compared to 24.1 percent at TPM facilities.
• 24.6 percent of TBC patients adhered to a diabetes care bundle, compared to 19.5 percent for TPM patients.
• 48.4 percent of TBC patients had documentation of self-care plans, while that number for TPM patients was only 8.7 percent.
• The overall payment was lower for TBC at $3,400, compared to $3,516 at TPM.
• Patients with controlled hypertension was 85 percent for TBC and 97.7 percent for TPM patients.

“The study suggests the value of coordinated team relationships within a delivery system emphasizing the integration of physical and mental health care. To our knowledge, this study has observed the largest cohort of patients, physicians or clinics involved in team-based care and longitudinally evaluated to date,” wrote Brenda Reiss-Brennan, PhD, APRN, lead author on the study. “It highlights the challenge of transforming physician practice over time to function as a team and manage the complexities of population health.”

Overall, according to the researchers, incorporating mental and physicals health together results in higher quality of care, lower rates of most acute care utilization and lower payments received.