Behavioral Health Integration

Behavioral Health Integration Consultants“Our hospital wants to find a behavioral health integration consultant to help us figure out the business aspect of our plan – start up costs, operating expenses, budget, staffing and finances.”

“Our health system is planning a behavioral health home but we don’t have the financial history we need to develop a budget. We are looking for a mental health home consultant to help us.”

“What is the best mental health home model for our hospital and is this financially feasible?”

Schafer Consulting brings innovative business, financial, and operations management experience to hospitals and health care systems developing behavioral health integration programs as well as mental health homes.

Some of our recent projects include: Developing a business plan for a 100,000+ visit per year psychiatric clinic system which is expanding its behavioral health and primary care integration program;  Collaborating with an academic medical center’s mental health home proposal to the state.

Behavioral Health Integration Consultant Services

Our behavioral health integration consultant team works with hospitals, health systems and academic medical centers to plan, assess, implement and monitor innovative care delivery models including: Stepped Care, MPACT, DIAMOND, SBIRT, and PIC. Our specific expertise is making integrated care work from three perspectives:

  1. Quality clinical outcomes
  2. Efficient daily operations and care coordination
  3. Financial viability

The types and degrees of behavioral health and primary care integration with which we have worked include:

  • Co-location and Linkage – Variable behavioral health staffing in primary care, some informal consultation and interface, some use of stepped model; some screening and tracking
  • Co-location and Basic Integration – Standardized staffing in primary care with behavioral health clinicians, full use of stepped model, consultation, and referral protocols; some screening and tracking variable by site
  • Integrated Population Management – Standardized staffing with minimum of a Licensed Independent Clinical Social Worker as a care partner and a consulting psychiatrist who can be remote; full screening, registry, and population management
  • Mental Health Homes – Coordination of all services for individuals with intensive psychiatric disorders and/or complex care needs


Preparing a Behavioral Health Integration Plan

We collaborate with health systems planning a behavioral health integration project. With proprietary and national behavioral health benchmarks we can help a hospital make their behavioral health integration operationally successful from both clinical and business perspectives.

Improving a Behavioral Health Integration Program’s Financial Stability

We have worked with hospitals providing integrated behavioral health and primary care services in their physician practices and clinics for the past ten years. Most often we are asked to conduct an operations assessment of their behavioral health integration in order to make these services more efficient and financially sustainable. The financial stability of behavioral health integration is an issue when start-up grants run out.

Based on a written assessment that uses real world business requirements, we make recommendations that include quantified opportunities for financial improvement.


Key Elements for Successful Behavioral Health Integration

To make integration successful it is important to realize that it is a volume driven business in addition to an innovative delivery system. Administratively managing “no shows”, cancellations, scheduling, referrals, client access, and provider productivity are all important.

Our 10-point checklist addresses these important elements:

  1. Integration Program model – Is this the best model for this patient population and hospital?
  2. Organization model – Is the organizational structure adequate for the volume and business needs of the organization?
  3. Utilization / Care Coordination– Is service delivery coordinated and managed effectively? Are “care partners” working directly with patients and primary care providers?
  4. Geographic structure – For multi-site systems, how are they managed and administratively supported?
  5. Productivity / Staffing and Staff Mix – Is productivity meeting national benchmarks? Are mid level practitioners utilized? Is the mix of therapists and prescribers optimal?
  6. Revenue cycle / revenue integrity – Are there opportunities to improve billing, point of service collections, and enroll patients in health insurance?
  7. Referral criteria – Are criteria clearly defined for referral to a behavioral health provider?
  8. Technology – Is the EMR capable of efficiently documenting, tracking, and reporting integrated services?
  9. Management tools – Are managers equipped with easy-to-use critical reports that provide at least weekly key metrics impacting costs and revenue?
  10. Value – Does the integration bring value to patients and serve the greater good?


Mental Health Home Consultant Services

Our mental and behavioral health home consultant specialists have worked with large safety-net hospitals planning and operating behaviorally focused medical homes. The goals of these hospital systems is to provide whole person care with better clinical outcomes and lower costs for people with complex mental health and medical needs.

Making a mental health home succeed relies on many of the same operational requirements as behavioral health and primary care integration.

Key characteristics of successful mental health homes are:

  • Patient-centered Philosophy
  • Comprehensive Care involving a team approach
  • Coordinated Care across both medical and psychiatric services with health information technology to support timely scheduling, coordination, and cost/data gathering and reporting
  • Accessible Care with 24/7 capability
  • Designated Care Managers or Complex Care Managers that 1) guide transitions from inpatient to other modalities, and 2) provide referral to community and social support services
  • Family support services
  • Quality Focused based on valid metrics frequently reviewed
  • Health Promotion and outreach


Recent Projects: Behavioral Health Primary Care Integration & Mental Health Home

  • Conducted an Operations Assessment of a health system’s extensive integration program and developed a Management Action Plan that improved staffing and patient care management in risk-based contracts with insurers while reducing operating costs.
  • Expanded and financially stabilized behavioral health integration across a safety net academic medical center’s Population Management project in its primary care system.
  • Planned a Mental Health Home to manage the needs of an intensive and complex patient population.
  • Developed the business plan for a health system’s five integration demonstration projects valued at $10 million over the next five years. The business plan addressed program model, site locations, staffing, productivity, costs, revenue, service tracking, and billing.
  • Designed a specialized Older Adults Integrated Behavioral Health and Primary Care / Assessment & Community Care Model.
  • Assessed and quantified the behavioral health needs of a population in a large hospital’s primary care delivery system.
  • Coordinated patient psychiatric and primary care across inpatient and outpatient services, especially for those with complex care needs.
  • Reviewed, revised, and developed the budget for a health system’s behavioral health Medicaid waiver proposal.


Talk to us

Since 1993, Schafer Consulting has uniquely specialized in behavioral health care operations. We have worked throughout the United States and Canada with large hospital systems and behavioral health service lines, to smaller, mission-driven social service agencies. We look forward to speaking with you about your specific needs in the Behavioral Health Integration field. Call (724) 213-0200 or contact us in confidence.