2020 Practitioner Survey: Medical and Behavioral Health Collaboration

  • October 7, 2021

    Premera conducts an annual provider survey on how primary care practitioners (PCPs) and behavioral health practitioners (BHPs) are collaborating to provide coordinated care for their patients. Screening for behavioral health disorders often happens during a primary care office visit and is a widely recognized standard of care.

    Working with Pacific Market Research, we collected data through a telephone survey of PCPs in all service areas. In 2020, the majority or 91% of the respondents were MDs and DOs, 4% were Nurse Practitioners, and 4% were Physician Assistants.

    Electronic Health Record Use

    The majority (89%) of PCPs use electronic health records (EHRs) regularly, a significant 8-percentage point increase from 2019. A third (36%) of the PCPs and BHPs use the same EHR and the majority (93%) of those use the EHR to access their patient’s behavioral health records.  The 64% of PCPs who don’t use the same EHR as their behavioral health (BH) colleagues, 76% are able to obtain BH records from another source.  In 2020, this improved by 4 percentage points; only 24% stated they had no access to behavioral health records from other sources.

    PCP Referrals to BH Practitioners

    PCPs were also asked, “When you diagnose depression, anxiety, ADHD, substance abuse, or an eating disorder, how often do you refer to a BHP practitioner or facility?”. PCPs refer more often for eating disorders (86%) and substance use (75%), than for ADHD (49%), depression (45%), and anxiety (43%). For those PCPs who do not refer, 94% stated they manage those patients’ conditions within the practice.

    Frequency of Screening

    Practitioners screen at least annually for depression (99%), anxiety (94%), substance abuse (94%), eating disorders (69%), and ADHD (65%). For their patients with diabetes, 86% of PCPs reported they screen for depression at least once yearly, 10% sometimes screen, while 3% of PCPs never screen for depression. 

    When screening for depression, 87% of PCPs screen by clinical interview, and 82% screen using a standardized depression instrument (PHQ, GAD-7).

    Areas for Improvement

    After a patient has been seen by a BHP, or admitted for BH services, only 56% of surveyed PCPs stated they usually or always receive a report back. This is a 6-percentage point decrease from 2019. PCPs stated they more often receive a report from an inpatient hospital (56%), behavioral health practitioner (39%), than from an out-patient program (32%).

    We continue to encourage all practitioners to collaborate and share information to improve the coordination of patient care and safety for patients accessing behavioral healthcare services.

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