Behavioral Health / Primary Care Integration and the Person-Centered Healthcare Home
Barbara J. Mauer
People living with serious mental illnesses are dying 25 year earlier than the rest of the population, in large part due to unmanaged physical health conditions. To address the gap in current thinking about this health disparity, this paper presents evidence-based approaches to a person-centered healthcare home for the population living with serious mental illnesses. In doing so, it brings together current developments around the patient-centered medical home with evidence-based approaches to the integration of primary care and behavioral health. In 2007, the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, and American Osteopathic Association released the following Joint Principles of the Patient-Centered Medical Home: each patient has an ongoing relationship with a personal physician; the personal physician leads a team of individuals at the practice level who collectively take responsibility for the ongoing care of patients; the personal physician is responsible for providing for all of the patient’s healthcare needs or appropriately arranging care with other qualified professionals; care is coordinated and/or integrated across all elements of the healthcare system; quality and safety are hallmarks; enhanced access to care is available; payment appropriately recognizes the added value provided to patients who have a patient-centered medical home. At the core of the clinical approach of the patient-centered medical home is team based care that provides care management and supports individuals in their self management goals. Care management is central to the shift in orientation embodied in the medical home away from a focus on episodic acute care to a focus on managing the health of defined populations, especially those living with chronic health conditions.