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Children benefit from the integration of behavioral health consultants at pediatric clinics, but can practices bear the cost?

November 3, 2021

While a growing body of evidence demonstrates the health benefits of embedding behavioral health care consultants into medical practices, many providers–including pediatric practitioners–are rightfully cautious about embarking on integration initiatives.

Integration is a complex process–one that requires a significant commitment of time and resources–and not all integration initiatives are economically sustainable.

Here, we provide a simple tool for determining whether or not a pediatric practice can sustain one or more behavioral health consultants, as well as an effective roadmap to integration.

What we did. From 2018 – 2020, the Center for Health and Research Transformation evaluated the effectiveness of two pediatric integration initiatives in Wayne County, a diverse county of 1.8 million in Southeast Michigan, to determine whether integration improved patient outcomes and the quality of pediatric care.

What we saw. Patients and physicians at both pediatric practices benefited from easy access to a trained behavioral health consultant. However, the sustainability of integrated care remained a challenge.

What we asked. Without a strong internal champion for integration, someone to remind staff of the benefits and help them overcome the challenges, practices must decide whether integration is, or isn’t, worth the time.

What we studied. To answer this question, we built a robust financial tool that allowed us to measure the costs of integration against the revenue generated through a range of billing and reimbursement models.

What we found. The economic viability of integration is contingent on four major factors:

  1. the size of the practice,
  2. the number of patients served,
  3. the way that the practice bills for behavioral health services, and
  4. the way that the practice is reimbursed by insurers.

Use our financial impact calculator to estimate the costs and benefits of behavioral health consulting for your pediatric practice.

Financial Impact Calculator