Patients do their best when medical and behavioral health providers communicate with each other about the patient’s care. According to the National Institute of Mental Health, primary care settings provide about half of all behavioral health care for common behavioral health conditions such as anxiety, depression, and ADHD.¹

Management of mental health in the primary care setting is crucial for expanding access for patients and for crisis intervention; coordination with a behavioral health specialist can benefit many patients. Dialogue between primary care providers (PCPs) and behavioral health providers can enhance providers’ ability to provide appropriate and patient-centered care. Coordination of care supports patient safety, risk identification, and adherence to treatment.

Coordinating with behavioral health services

For our members with new or known behavioral health disorders, we expect providers to discuss behavioral health services with the patient or their caregiver and refer the patient to behavioral health specialists, as appropriate. Follow up is an essential component of appropriate management, including regular communication with specialists providing behavioral health services to your patients.

Shared information can include, but is not limited to:

• Management of medications and other treatments, especially:
• increased clinical risks, such as with antipsychotics which may increase risk for metabolic syndrome;
• polypharmacy and medication interactions;
• side effects that could influence compliance with either medical or behavioral health care.
• coordination of appropriate tests to be ordered and results monitored;
• how behavioral health conditions may be interacting with, exacerbating, or mimicking medical conditions;
• the influence of behavioral health stressors on medical symptoms;
• social determinants of health that may influence health outcomes;
• attempts to reduce errors in care through increased communication.

Be proactive

Reach out to your patients’ behavioral health providers to coordinate their care rather than waiting for the specialist to contact you. Please remember to document each communication with your patients’ other providers as well as the patients’ consent for release of information.

The role of AmeriHealth in supporting collaboration

The AmeriHealth Quality Management department regularly assesses coordination of medical-behavioral health care in our network. This analysis includes reviewing medical records for the care provided to our members with depression and/or attention deficit hyperactivity disorder. In the most recent medical record review sample of AmeriHealth Pennsylvania and AmeriHealth New Jersey members, we identified 71 members with documentation of a newly diagnosed behavioral health condition and 265 members with documentation of a known behavioral health diagnosis. Of those members with an identified behavioral health condition, documentation of a discussion of behavioral health services was found in 49 percent of charts for newly diagnosed members and 26 percent with a known behavioral health condition. There was no documentation of communication between medical and behavioral health providers.

Resources

Our members deserve a comprehensive approach to their mental and physical wellbeing. We understand that many providers are concerned about respecting patients’ privacy when it comes to mental healthcare. We encourage you to discuss the importance of coordinated medical and behavioral care with patients. Educate patients about how sharing information helps to identify and reduce potential mental and physical health risks. Provide your patients clear direction on what information will be shared and provide them an opportunity to give their written consent for records exchange. To facilitate collaboration and coordination in care between PCPs and behavioral health providers, AmeriHealth and Magellan Healthcare, Inc. (Magellan) provide resources for providers:

• Clinician Collaboration Form. A one-page template form highlighting vital information about a patient’s behavioral and medical health care and concerns. The form can be exchanged electronically or by mail to the receiving provider. Providers must obtain patient consent prior to exchanging patients’ personal information and discussing their mental health care.
• Magellan’s Behavioral Health Disorders Toolkit.A collection of resources that medical practitioners need to identify potential behavioral health concerns and assist in making behavioral health referrals. The online toolkit contains descriptions of common behavioral health concerns (including substance use), user-friendly screening tools, patient handouts, provider tip sheets, informational materials and more.

To access the Clinical Collaboration Form and theBehavioral Health Disorders Toolkit visit the Resources for Patient Management webpage for AmeriHealth New Jersey and the Worksheets, Forms, and Guides webpage for AmeriHealth Pennsylvania.

For more information on other available tools and resources, please visit the Magellan website or go to AmeriHealth NaviNet^? Plan Central and select Health and Wellness under Administrative Tools & Resources.

¹nimh.nih.gov/health/topics/integrated-care/index.shtml

Magellan Healthcare, Inc. manages mental health and substance abuse benefits for most AmeriHealth members,

NaviNet^® is a registered trademark of NantHealth.