2024 Survey: Important Insights on Medical and Behavioral Health Collaboration
Premera conducts an annual provider survey about coordination between primary care practitioners (PCPs) and behavioral health practitioners (BHPs). Screening for behavioral health disorders often happens in the primary care office visit and is a widely recognized practice.
A telephone survey of PCPs in all service areas was conducted by Pacific Market Research. For the 2024 survey, the majority or 90% of the respondents were MDs and DOs. ARNPs (5%), and PAs (4%). Key findings include:
Integrated behavioral health services
Two out of five or 43% of PCPs have integrated behavioral health services in their clinics. Of those who have integrated BH services, about half use the Primary Care Behavioral Health (PCBH) model and half use the Collaborative Care Model.
Electronic medical record use
We asked PCPs about their use of electronic medical records (EMRs). 92% of PCP organizations use EMRs and 93% of PCPs reported they use the EMRs regularly. A significant 59% of the PCPs stated they use the same EMR as their behavioral health colleagues, and 91% of those PCPs use the EMR to review their patients’ BH records. Among the 41% of PCPs who do not use the same EMR as their behavioral health colleagues, 58% are able to obtain BH records from another source. 42% of the PCPs stated they had no access to BH records from other sources.
Frequency of screening
Practitioners screen at least annually for depression (96%), anxiety (93%), substance abuse (94%), and attention deficit hyperactivity disorder (ADHD) (64%). For their patients with diabetes, 90% of PCPs reported they screen for depression “usually or always” at least once yearly, 7% screen “sometimes”, and 3% of PCPs stated they “never” screen their patients with diabetes for depression. When screening for depression/anxiety, 88% of PCPs screen by clinical interview, and 85% screen using a standardized depression instrument, a PHQ-9 or GAD-7.
PCP referrals to behavioral health practitioners
PCPs were also asked, “When you diagnose depression, anxiety, substance abuse, or ADHD, how often do you usually or always refer to a BH practitioner or facility?” PCPs refer more often for substance abuse (68%), than for ADHD (45%), depression (44%), and anxiety (42%). For those PCPs who do not refer, 95%, (a 4-percentage point decrease from 2023) 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 BH services, only 49% of surveyed PCPs stated they “usually or always” receive a discharge summary back from an inpatient hospital, from a behavioral health practitioner (39%), or from an outpatient program/facility (32%).
We encourage all BH practitioners to collaborate with their PCP colleagues. Sharing information about the patient’s treatment plan and prescribed medications is critical to improve coordination, safety, and provide a better experience for the patient accessing behavioral healthcare services.