Challenge: A midsize primary care clinic has recognized that they consistently have waitlists for their specialty mental health providers and would like to enhance access for their patients, figure out a more financially sustainable options for their mental health/behavioral health services, improve their PCP's understanding of the overall comprehensive needs of their patients, and be eligible for more grants or other funding based off of a measure-based, data driven outcomes approach to their integrated care services. They have 3 onsite MH licensed providers working FT who provide traditional psychotherapy. Wait times for patients are up to 3 months, they have a 30% no show and cancellation rate and their productivity/access is the following MH provider 1 is at 2 patients per day average, MH provider 2 is at 3 patients per day average, and MH provider 3 is at 4.5 patients per day average. The providers do not use screening tools or measurements for outcomes. They do measure patient satisfaction which is always the highest scores at the clinic. In addition, there is a 3 month wait for their psychiatrist (only 1 hired); although, they only have 5 patient appointments per day and have the highest no show rate for initial appointments resulting in average of seeing 3.5 people per day. Both MH providers and the psychiatrist create their own schedule template and alert the front desk on who to schedule and when to place blocks. They block their schedules weekly for case conferencing, training, and 4 hours per week for paperwork. There are no measurements for outcomes for the psychiatrist other than patient satisfaction which is positive. The clinic sees pts across all ages (birth to older persons) and they have telehealth offerings and a school based referral network as well and have considered extending services more. PCPs are the clinics main income and providers of care with 15 pcps. They report feeling overwhelmed with the SDOH and behavioral/mental health concerns of their populations and not knowing how to assess or manage pt needs. They also are concerned with prescribing psychotropic medications; although, at times, they do - but mostly like to refer to the psychiatrist. PCPs are evaluated by HEDIS, UDS, and Medicare required outcomes and have fee for service and value based payment arrangements. The goal is not only to inform, but to engage and enhance buy-in from everyone; PCPs, practice administration, clinical staff, clerical and front desk staff, etc. In doing this, consider optimal management skills of communication and collaboration in relating to the practice as these will assist you in eliciting needed support and enthusiasm for this transformation.

Transformation

1. Overall what needs to happen to initiate change. Training needs (name specific on-boarding and ongoing training requirements needed for your solution) and identify for who (behavioral health, specialty, staff, medical providers, leadership, etc.)

Overview

2. Procedures

3. Key performance indicators

4. Financial planning (plan for billing, reimbursement, cost savings or sharing, or ROI

5. Discuss how to to measure success.

6.Define in terms of your plan for goals and expected outcomes for measuring success.

7. Provide 3 (minimum) SMART (provide clearly identified specific, measurable, actionable, realistic, and time bound goals and expected outcomes) metrics.

8. How do you see this benefiting the practice/ patients?

9. Express a compelling reason to motivate the participants to want to engage.