Abstract
A residency-based Family Medicine outpatient clinic chose to implement an integrated behavioral health care program in a large primary care clinic in the Southeast to improve patient access to behavioral health care. We hypothesized that embedding a BHP in a primary care setting would be a cost neutral intervention. We implemented a prospective cohort design and included expenses from both inpatient and outpatient visits. We implemented a mixed effects linear regression model to evaluate pre- and post-BHP exposure costs. A total of 1256 patients were identified in the post-BHP exposure period that had more than one-year post-exposure. After applying exclusion criteria, there were 926 patients included in analysis. These patient had an average total cost during the one-year pre-BHP exposure period of $5113 (SD = 7712) and one-year post-BHP exposure period of $5462 (SD = 7813). Our analysis shows a relatively cost neutral impact following the introduction of BHPs in a primary care setting. The results of this study provide a gauge for future planning of services.
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Acknowledgements
We would like to acknowledge our Behavioral Health Providers that have delivered the care on the front lines including Holly D. Hallman, MSW, LCSW; Katherine G. Hyland, MA, LCMHC; Linda P. McRae, PsyD, MDiv, LCSW, LCAS; and Rosalinda B. Thomas, Med, LCAS
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Health Resources and Services Administration T0BHP28568 Primary Care Training and Enhancement.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Edward Ip, Steve Davis, and Joseph Hilburn. The first draft of the manuscript was written by Aubry Koehler and Julie Kirk and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Aubry N. Koehler, Edward Ip, Stephen W. Davis, Joseph F. Hilburn, Richard W. Lord Jr., Gail S. Marion and Julienne K. Kirk declare that they have no conflict of interest.
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Protocol and patient informed consent approved by the Wake Forest School of Medicine Institutional Review Board (IRB00034196).
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The methodology for this study was approved by the Institutional Review Board of the Wake Forest School of Medicine (IRB00034196).
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Koehler, A.N., Ip, E., Davis, S.W. et al. Cost Analysis of Integrated Behavioral Health in a Large Primary Care Practice. J Clin Psychol Med Settings 29, 446–452 (2022). https://doi.org/10.1007/s10880-022-09866-9
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DOI: https://doi.org/10.1007/s10880-022-09866-9