Collaborating with Primary Care
Addressing the Impact of Co-occurring Behavioral and Physical Health Conditions – Transforming Client Outcomes
Purpose
Clients experience better outcomes when care is coordinated between all healthcare providers. In alignment with Value Based Care expectations and the CCBHC Model, Behavioral Health Organizations need to implement strategies to screen for primary care conditions and collaborate with physical healthcare providers through care coordination practices.
MTM’s Primary Care Integration Module will provide an objective review of the organization’s current level of healthcare screening and engagement with primary care. Consultant will work with a project team to design a plan for implementing the needed changes to facilitate whole health assessment and effective collaboration with primary care and specialty healthcare providers in the community.
Process
Planning meeting with project team to review written plan of roles, responsibilities, and time frames related to the project
Analysis of current engagement with primary care and specialty healthcare providers
Review of strategies for healthcare screening and collaboration with medical providers in the community
Creating a plan to redesign healthcare screening and collaborative practices throughout the organization including a project management outline that addresses the implementation timeline, communication plan, training needs and maintenance strategies.
Timeframe: 4 months
Outcomes:
● Active utilization of Needs Assessment Data
● Increased System of Care engagement
● Improved care integration and client outcomes
● Successful implementation of critical CCBHC Requirement
● Significant Risk Reduction
MTM Team
MD, FASM
Medical Operations, Care Integration & Senior National Council Consultant