I’ll start this blog by stating the obvious – Integrating behavioral healthcare (with primary care) enables whole person care for millions suffering from debilitating behavioral health (BH) conditions. 

The not-so-obvious aspect of this integration – How pairing Behavioral Health Integration (BHI) with Chronic Care Management (CCM) simplifies the administrative process for care management programs, leading to greater efficiency.

As a Medicare program that focuses on mental health assessments and monitoring to personalize care and engage patients, BHI represents a much-needed shift to holistic healthcare delivery. Especially because – 

• More than 50% of Americans live with a chronic illness
• Of this population, one-third also live with a diagnosed BH condition, and 
• Despite such a large section of the population suffering from co-occurring illnesses, patients don’t have access to integrated care

What Should You Know About The CCM—BHI Equation?

I’ll begin this section too by stating the obvious – CCM, a Medicare reimbursement program for beneficiaries with multiple chronic conditions, consists of –

• Evidence- and population-based direct treatment of illness 
• Patient-centered treatment teams
• Coordinated care delivery

The not-so-known fact? – CCM is one of the most common integrated care models in the BHI ecosystem. It consists of a collaboration-driven treatment team, and is intricately tied to the Patient-Centered Medical Home model that is critical in keeping patients engaged during the course of their treatment.

That said, you are already aware about the eligible beneficiaries of – 

• BHI being patients with any BH or psychiatric condition being treated by a billing practitioner
• CCM being patients with two or more chronic conditions expected to last at least 12 months

I’ve found a tabular listing of the difference between the two (as mentioned below) to work well as an easy reckoner –

Interestingly, CCM in combination with BHI helps the average single-doctor practice generate almost $11,000 per month with 100 patients enrolled in both.

How Can You Integrate BHI With CCM?

For care practices, integrating BHI and CCM makes sense because of the following key reasons –

• Increase in patient enrolment – By introducing BHI as a Medicare benefit, the stigma patients face while seeking treatment for BH disorders has been found to reduce significantly
• Reduction in costs – Priority-driven allocation of resources and responsibilities allows physicians to isolate specific BH concerns, followed by timely and suitable corrective action
• Improvement in revenue – Like I’ve mentioned in the previous section, both BHI and CCM generate reimbursements for 20 minutes of non-face-to-face interactions per patient. The sum of the two nearly doubles the income per month.

In fact, insurance providers (too) that are proactively integrating personalized evidence- and measurement-based care into their CCM and BH plans are demonstrating both the aforementioned outcomes.

AI-guided software solutions, like Urban Health, help practices embrace integrated care by – 

• Successfully implementing BHI
• Streamlining mental health assessments
• Maximizing Medicare incentive payments

Urban Health is a pathbreaking evidence- and measurement-based, patient group-agnostic BH therapy and care-enabling solution that can help you with – 

• Live dashboards for real-time tracking and managing of clinical activities
• Live BHI time logs, accompanied with audit trail generation for accurate billing and claims
• Automatic assignment of CPT codes and conditions to claims (based on time spent with patient)

Benefits include, but are not limited to – 

• Enhanced patient engagement, leading to increased patient enrolment
• Seamless management of multiple care management programs simultaneously
• Cost-effective delivery of integrated mental healthcare at scale
• Resolution of reimbursement challenges
• Improved revenue generation

To know more about how Urban Health is driving cost-effective, timely and appropriate care coordination and how organizations are benefiting from our BHI+ Program, please click here.