April 6, 2023
Premera conducts an annual provider survey about coordination between primary care practitioners (PCPs) and behavioral health practitioners (BHPs). Screening for behavioral health disorders often happens in the primary care office visit and is a widely recognized practice.
The phone survey of PCPs in all service areas was conducted by Pacific Market Research. For the 2022 survey, the majority or 91% of the respondents were MDs and DOs, and the other 9% were ARNPs and PAs.
Key findings include:
- Integrated Behavioral Health Services
Two out of five (40%) of PCPs have integrated behavioral health (BH) services in their clinics. Of those who have integrated BH services, 83% use the Primary Care Behavioral Health (PCBH) model and 58% of the PCPs use the Collaborative Care Model.
- Electronic Medical Record (EMR) Use
We asked PCPs about their use of EMRs. 91% of PCP organizations use EMRs and 90% of PCPs reported they use the EMR regularly. Only 43% of the PCPs stated they use the same EMR as their BH colleagues, and 89% of those PCPs use the EMR to review their patients BH records. Among the 57% of PCPs who do not use the same EHR as their Behavioral Health colleagues, 69% are able to obtain BH records from another source. 31% of the PCPs stated they had no access to BH 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 usually or always refer to a BH practitioner or facility?” PCPs refer more often for eating disorders (83%) and substance use (77%), than for ADHD (50%), depression (50%), and anxiety (49%). For those PCPs who do not refer, 87%, (a 9-percentage point decrease from the previous year) stated they manage those patients’ conditions within their practice.
- Frequency of Screening
Practitioners screen at least annually for depression (98%), anxiety (95%), substance abuse (95%), eating disorders (62%), and ADHD (56%). For their patients with diabetes, 86% of PCPs reported they screen for depression at least once yearly, 12% screen “sometimes”, while 3% of PCPs stated they “never” screen their patients with diabetes for depression. When screening for depression, 82% of PCPs screen by clinical interview, and 85% screen using a standardized depression instrument, a PHQ or GAD-7.
- Areas for Improvement – Patient Safety
After a patient has been seen by a BHP, or admitted for BH services, only 50% of surveyed PCPs stated they “usually or always” receive a discharge summary back for an in-patient hospital stay. Only 35% reported they receive a report from a BH practitioner, and 33% reported they receive a report from an out-patient facility.
We encourage all BH practitioners to collaborate with their PCP colleagues. Sharing information about the patient’s treatment plan and prescribed medications improve coordination and safety for patients accessing behavioral healthcare services.
the National Committee for Quality Assurance (NCQA).