PeaceHealth Oregon West Network – Behavioral Health Integration

Overview

PeaceHealth is a family of hospitals, clinics, and doctors, based in the Pacific Northwest. This network of faith-based, mission-oriented facilities has grown to include services throughout Oregon, Washington and Alaska. PeaceHealth Oregon West Network is one of four networks offering a broad spectrum of medical care. This network has three medical centers in Eugene, Springfield and Cottage Grove, and a critical access hospital in Florence. In addition, there are 12 primary and specialty care clinics as well as outpatient laboratory facilities in each municipality. Oregon West Network has become a leader of health care delivery services in Oregon, especially in the delivery of behavioral health services for those residents who are most vulnerable.

PeaceHealth Behavioral Health Services (BHS) is composed of a continuum of care that provides a range of services, including inpatient psychiatric care, partial hospitalization, transition services, telemental health, crisis services, outpatient psychiatry and counseling, research projects, primary care integration, young adult and first-episode psychosis-specific treatments.

PeaceHealth began integrating behavioral health support into its primary care setting in 2009. A behavioral health consultant and psychiatric medical assistant were embedded full-time into a primary care clinic to provide brief behavioral health interventions and coaching related to physical health concerns. In 2010, PeaceHealth received a grant from Pacific Source Health Plan to better support and strengthen the integration project. The focus of this grant was on improving outcomes for patients with diabetes and depression. In 2014, PeaceHealth expanded this “Enhanced Wellness” program to include three behavioral health consultants assigned to primary care clinics. The health system also launched a “Behavioral Health Medical Home” to provide primary care as part of the behavioral health clinic. The primary care nurse practitioner coordinates closely with the transdisciplinary team to provide holistic care.

Impact

The interventions provided through the “Enhanced Wellness” project resulted in the majority of patients receiving care through the program demonstrating reduced A1C levels and lower PHQ9 scores. The current behavioral health consultants provide interventions to up to 10 primary care patients each day. Outcome data is currently tracked for the new program expansions, and preliminary analysis will begin after the end of the fiscal year. The Behavioral Health Medical Home is providing intensive support to 125 patients.

Lessons Learned

After conducting this type of care for more than five years, it is clear that providing this service is not optional. The ability to provide “just in time” behavioral health care to those patients in primary care makes it possible to keep people from requiring more extensive and/or expensive care later on. These brief interventions also help patients achieve their physical health goals because the behavioral health consultants use care pathways that guide the patient along a path of recovery or healthy maintenance using motivational strategies. Using wellness tools such as the Generalized Self-Efficacy 6 and the HR-QoL (quality of life measure) have shown that patients’ overall quality of life does in fact improve with the use of behavioral health consultants embedded in the primary care clinic.

Patients who have never before engaged in primary care treatment are now receiving regular preventive care through the Behavioral Health Medical Home. The clinic is able to address no-show issues through community outreach, providing transportation and home visits when needed.

Future Goals

One future goal is to develop a sustainable payment model that will support this model of care. PeaceHealth has committed to expanding both integration projects in the next fiscal year, including the addition of consultants in all PeaceHealth primary care clinics.

Contact: Mary Anne McMurren
Vice President, Post-Acute Services
Telephone: 541-338-1656
Email: mmcmurren@peacehealth.org