R.I. Blue Cross Organization, Lifespan Pilot Integrated Behavioral Health Model

Blue Cross & Blue Shield of Rhode Island has developed a pilot program intended to make it easier for members to receive behavioral healthcare through a collaboration between primary care providers (PCPs) and behavioral health practitioners.

The pilot incorporates an alternative payment model that aligns provider payment to quality and cost efficiency. The Women’s Medicine Collaborative at integrated academic health system Lifespan is the first healthcare provider in the state to participate in the pilot.

BCBSRI and Lifespan’s Women’s Medicine Collaborative launched the pilot in April 2021. Participating PCPs receive clinical support from BCBSRI to better identify and manage patients with behavioral health conditions such as depression and anxiety, who are often treated in a primary care setting.

The two-year pilot program will be measured by how it improves patient outcomes, with goals such as:

• Real-time access to behavioral health treatment and care management at the time of a patient’s screening.

• Care that is coordinated between the PCP and the behavioral health specialist that creates a better patient experience and promotes better outcomes.

• A high-touch highly coordinated model that will provide the education and support patients need to make informed treatment decisions, leading to better outcomes and patient engagement.

The program will measure warm handoffs — transfer of care between the PCP and the behavioral health provider — for patients the PCP has identified as having a behavioral health need. This handoff is planned to be seamless for the patient and provides for an immediate conversation, whether virtual or in-person, with the behavioral health provider. The program will also measure if patients take their anti-depressant medications as prescribed.

“Under a collaborative care model, primary care and behavioral health providers are able to partner on shared care plans that incorporate the same goals – improving access to care and improving patient outcomes,” said Rena Sheehan, M.B.A., L.I.C.S.W., vice president of clinical integration at BCBSRI, in a statement. “We know that integrated behavioral health and primary care has demonstrated positive impacts to the quadruple aim to improve the experience of care, improve the health of populations, reduce the per capita costs of healthcare and improve the work life of healthcare providers. This new pilot program allows us to better capture the population health management and care coordination components critical to successful integrated programs.”