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2023 Provider Survey Results: Medical and Behavioral Health Collaboration

February 1, 2024

Coordination between medical and behavioral healthcare

Coordination of a patient’s care between primary care physicians (PCPs) and behavioral care physicians (BHPs) can provide better care for patients. That’s why Premera surveys providers in our networks annually to better understand how PCPs and BHPs stay connected to support a patient’s care. Screening for behavioral health disorders often happens in the primary care office visit and is a widely recognized practice.

A 2023 telephone survey of PCPs in all service areas was conducted by Pacific Market Research. For the 2023 survey, the majority or 95% of the respondents were MDs and DOs; the other 5% consisted of ARNPs and PAs. Key findings include:

Integrated behavioral health services

Two out of five or 40% of PCPs have integrated behavioral health services in their clinics. Of those who have integrated BH services, 81% use the Primary Care Behavioral Health (PCBH) model and 71% of the PCPs stated they use the Collaborative Care Model.

Electronic medical record use

We asked PCPs about their use of electronic medical records (EMRs). 93% of PCP organizations use EMRs and 93% of PCPs reported they use EMRs regularly. Only 42% of PCPs stated they use the same EMR as their behavioral health colleagues, and 94% of those PCPs use the EMR to review their patients’ behavioral health records. Among the 58% of PCPs who do not use the same EHR as their behavioral health colleagues, 59% are able to obtain behavioral health records from another source. 41% of the PCPs stated they had no access to behavioral health records from other sources.

Frequency of screening

Providers screen at least annually for depression (99%), anxiety (95%), substance abuse (94%), and attention deficit hyperactivity disorder (ADHD) (63%). For their patients with diabetes, 90% of PCPs reported they screen for depression “usually or always” at least once yearly, 9% screen “sometimes”, and 1% of PCPs stated they “never” screen their patients with diabetes for depression. When screening for depression/anxiety, 82% of PCPs screen by clinical interview, and 88% screen using a standardized depression instrument, a PHQ-9 or GAD-7.

PCP referrals to behavioral health providers

PCPs were also asked, “When you diagnose depression, anxiety, substance abuse, or ADHD, how often do you “usually or always refer to a behavioral health practitioner or facility?” PCPs refer more often for substance abuse (68%), than for depression (43%), ADHD (41%), and anxiety (41%). For those PCPs who don’t refer, 99%, (a 12-percentage point increase from the previous year) stated they manage those patients’ conditions within their practice.

Areas for Improvement – Patient Safety

After a patient has been seen by a BHP or admitted for behavioral health services, only 44% of surveyed PCPs stated they “usually or always” receive a discharge summary back from an inpatient hospital, from a BHP (30%), or from an outpatient program/facility (22%).

We encourage all behavioral health providers to collaborate with their PCP colleagues. Sharing information about a patient’s treatment plan and prescribed medications improves coordination and safety and provides a better experience for patients accessing behavioral healthcare services.