Dartmouth Institute researchers working to further
our understanding of how, and if, mental health is integrated in primary care under ACOs.
Patients with serious mental illness often also have complex physical health needs. Historically, the health care system in the United States has separated treatment of mental health needs from physical health needs. The result of this care fragmentation—combined with the psychosocial needs of many patients with mental illness—is that people with mental illness have worse physical health outcomes and shorter life expectancies than their counterparts without mental illness.
New payment models that focus on both quality and cost of care, such as accountable care organizations (ACOs), give networks of health care providers incentives to integrate and coordinate care. These models of care have the potential to improve mental health care quality by improving the integration of physical health and mental health services.
In a 2014 study in Health Affairs, researchers at The Dartmouth Institute showed that fewer than 15% of ACOs nationally integrated behavioral health into primary care settings. Under a grant from the National Institutes of Mental Health (NIH), Mental Health Under New Strategies, a team of Dartmouth Institute researchers, led by health economist Ellen Meara, will seek to build upon this work and further our understanding of how, and if, mental health is integrated in primary care under ACOs.
OF ACOS NATIONALLY HAVE INTEGRATED BEHAVIORAL HEALTH INTO PRIMARY CARE SETTINGS.
In the fourth and largest wave of the Dartmouth Insitute-run National Survey of ACOs (NSACO), nearly 1,000 provider organizations with ACO and ACO-like contracts will be surveyed. Meara and the research team are asking organizations whether and how emerging contracts between providers and insurers try to address physical and mental health care for patients with mental illness. By linking survey data on Medicare patients to data on health care use, they will examine whether particular organizational and contract features are associated with the quality of mental and physical health care for patients with mental illness.
Susan Busch (Yale), Chiang-Hua Chang, Valerie Lewis, Donovan Maust (University of Michigan), Kristen Peck
For additional information on the NSACO, contact