CCMS Medicine Winter 2017 - 18

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The Benefits and Challenges
of Behavioral Health Services
in the Medical Setting
BY VINCENT J. BELLWOAR, PH.D., & TROY L. BRINDLE, LCSW

A

key tenet of healthcare reform is the Patient Centered
Medical Home Model (PCMH). Primary care physicians
(PCPs) sit at the epicenter of this reform as they
identify, treat and manage the patient's overall care. Those who
tout healthcare reform advocate strongly for behavioral health
interventions at the PCP level. To better address these needs, many
PCPs seek to integrate behavioral health (BH) services within
their practice. Emerging models include the use of care managers,
behavioral health specialists, and consultation.
Some large hospital systems or physician practices have
attempted to directly hire BH providers. In doing so, some have
met with success while others continue to struggle. We believe a
viable alternative is for hospitals or physician groups to partner
with independent BH practices who can then offer a range of
services while also being flexible enough to meet patient needs.
Partnering allows BH providers to remain financially independent
of the medical group while aiming for clinically aligned if not
integrated services.
Springfield Psychological is a large multispecialty outpatient
practice that began providing co-located BH services in PCP
offices throughout southeastern PA in 2013. We started in one
PCMH office for four hours a week after convincing physicians
and their staff that co-located BH care would be good for their
patients, the PCP's stature in the community and their relationship
with insurers. We promised to decrease their headaches by dealing

18 C H E S T E R C O U N T Y M e d i c i n e | W I N T E R 2 0 1 7

with difficult patients whose needs went beyond the physicians'
training and limited schedules. We advocated that easier access to
BH services would result in healthier patients. We assured them
they could part ways from us immediately if they wanted, or, more
importantly, we could easily replace an ineffective BH provider
with another clinician. (Sometimes the fit just isn't good, but when
that happens, there is no need to shelve the whole operation.) In
short, our philosophy centers on the belief that BH services in
the medical world are a necessity for healthcare reform, to create a
healthier patient population.
With persistence, flexibility and creativity, we won over the
first practice and within four months they were asking us for
more time. In approaching the physician as a consumer, we spent
substantial energies and resources doing what was necessary to
effectively collaborate with them and their patients. From that
first PCMH practice we have expanded to twenty other PCMH
offices and have moved into specialty practices as well, including
an Oncology and Hematology group.
Of course, winning over the physicians and their staff is the
first obstacle to overcome. Choosing the right BH provider is
the next challenge. BH providers must embrace the fast-paced
environment. They need to successfully navigate the challenge of
winning over physicians and their staff. They must be comfortable
with managing paperwork for new patients and attend to
collecting copays each visit. They must be dynamic, engaging


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Table of Contents for the Digital Edition of CCMS Medicine Winter 2017

CCMS Medicine Winter 2017 - 1
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