Small Primary Care Practices that Offer Behavioral Health Services Successfully Identifying Patients at Risk of Depression

NEW YORK, NEW YORK May 30, 2018—Small primary care practices participating in a project to offer behavioral health services are successfully identifying people at risk for depression. Those practices now also view routine screening for depression as equal to checking patients' vital signs and blood pressure, according to a report issued today by United Hospital Fund (UHF).

One in five New Yorkers suffer from common mental health disorders such as depression and anxiety, which have a direct impact on physical health. However, some 80 percent of patients in a primary care practice who have behavioral health issues go undiagnosed or undertreated. Integrating mental health services into primary care practices provides a promising gateway to reach these patients, and help them get the care they need.

The report, Advancing Behavioral Health Integration for Small Primary Care Practices: Progress, Emerging Themes, and Policy Considerations, documents progress to date in a project, launched in 2016 by UHF and the New York State Health Foundation (NYSHealth), helping primary care providers pilot-test a framework to integrate behavioral health care into their practices. The report examines the progress of 11 small New York practices participating in the project—six in New York City and five upstate.

“Too many patients have no access to mental health services, yet when depression and anxiety go untreated they can cause considerable suffering and increase the cost of overall patient care,” said report co-author Henry Chung, MD, senior medical director, Montefiore Care Management Organization, and professor of psychiatry at Albert Einstein College of Medicine. “By implementing high-quality behavioral health services into primary care practices, providers are giving patients more treatment options and improving their overall health outcomes.”

The practices participating in the project reported that their integration efforts resulted in improved quality of care. They were able to better identify and treat patients with depression using evidence-based approaches, and help them self-manage and coordinate their health and behavioral care. Revenues began to increase as well, as practices began to bill for mental health screening. Practices achieved these results despite ongoing challenges in working with payers to ensure appropriate and consistent reimbursement. Nevertheless, without more revenue options to support evidence-based behavioral health integration in primary care, sustainability will remain a challenge.

“Patients want to access mental health services from someone they trust,” said Brian Byrd, program officer at NYSHealth. “This Framework enables small-practice providers to meet this need.”

The report includes case studies of three participating practices: Keuka Family Practice in Bath, NY; Koinonia Primary Care in Albany, NY; and Delmont Medical Care in Queens, NY, as well as a summary of a pay-for-performance program launched by Empire BlueCross BlueShield, a subsidiary of Anthem, Inc., in 2017 to encourage behavioral health providers to collaborate with local primary care providers.

“We believe that the Framework will help even very small primary care practices better serve the needs of their patients and improve quality and cost of care,” said Gregory C. Burke, director of Innovation Strategies for UHF.

The project will release a final report in late fall 2018. A PDF of the interim report can be downloaded here.

About United Hospital Fund
United Hospital Fund works to build a more effective health care system for every New Yorker. An independent, nonprofit organization, we analyze public policy to inform decision-makers, find common ground among diverse stakeholders, and develop and support innovative programs that improve the quality, accessibility, affordability, and experience of patient care. For more on our initiatives and programs please visit our website at and follow us on Twitter.

About The New York State Health Foundation
The New York State Health Foundation (NYSHealth) is a private, statewide foundation dedicated to improving the health of all New Yorkers, especially the most vulnerable. Today, NYSHealth concentrates its work in two strategic priority areas: building healthy communities and empowering health care consumers. The Foundation is committed to making grants, informing health policy and practice, spreading effective programs to improve the health care system and the health of New Yorkers, serving as a neutral convener of health leaders across the State, and providing technical assistance to its grantees and partners.

May 30, 2018
Focus Area
Clinical-Community PartnershipsQuality and EfficiencyCoverage and Access
Innovation Strategies