The Connection Between Physical and Behavioral Health – And How Value-Based Payments Can Incentivize Integrated Care Plans That Address Both
Integrated care plans are necessary to provide whole-person care and achieve optimal health outcomes
THE VBP Blog
December 1, 2022 – The mind and body are often viewed as separate entities, but behavioral health, which includes mental health, and physical health are very closely related. In order to achieve optimal health outcomes requires more than just physical health needs should be met. Behavioral health must also be addressed through whole-person, integrated healthcare plans.
In this blog, we will take a deep dive into the connection between behavioral and physical health, why integrated care plans matter, and how value-based payments play a role in incentivizing integrated health care.
The Connection Between Behavioral and Physical Health
Studies have shown that those with behavioral health issues are more likely to have a preventable physical health condition. And, almost one in three people with a long-term physical health condition also has a mental health problem. As you can see, physical and behavioral health are not their own silos. Both aspects are interconnected and play a role in overall health outcomes.
So, let’s take a deeper look at the interplay between behavioral and physical health so you can better understand how they are related.
Mental health, a large component of behavioral health, has been closely linked to overall health according to numerous studies, including one by Anne M. Doherty and Fiona Gaughran in Social Psychiatry and Psychiatric Epidemiology. Poor mental health can lead to poor physical health. For example, depression has been linked to chronic illnesses, including diabetes, cancer, cardiovascular disease, and arthritis. Schizophrenia has also been linked to a higher risk of respiratory and heart diseases. Those with mental health conditions are also more likely to suffer from sleep disorders like sleep apnea and insomnia. These are just a few examples of how behavioral health can impact physical health.
Alternately, physical health also impacts behavioral health. Those diagnosed with cancer or that suffer a heart attack often report feeling depressed or anxious. One report from the Cleveland Clinic discusses how one-third of people with a serious medical condition reported symptoms of depression, including sleep problems, loss of interest in daily activities, and poor mood.
Why Integrated Health Care Plans Matter
Integrated healthcare plans are a unique approach to healthcare that is characterized by collaboration and communication between healthcare providers to ensure that all needs of a person are addressed. These plans involve medical professionals working together to solve issues related to physical, mental, and behavioral health, instead of dealing with those issues in a silo.
We mentioned previously how tightly connected physical and behavioral health are, which is why it is important that people can easily get whole-person care and not be forced to deal with fragmented, siloed systems. This is where Accountable Care Organizations (ACOs) come into play. An ACO is a group of doctors, hospitals, and healthcare providers that come together to provide coordinated and high-quality care. This is one way to combat siloed care and ACOs have seen success.
There are many benefits to integrated health care that also need to be considered. The first is improved quality of care and better health outcomes. Integrated healthcare provides better care because providers are collaborating closely to ensure the unique needs of each patient and how best to address them.
Integrated healthcare can also lead to lower overall healthcare costs. When medical professionals collaborate and work together, it leads to lower costs because patients get the care and services they need with fewer appointments. In conjunction with enhanced information sharing, integrated health care can speed up diagnosis and reduce redundant medical tests and exams, which also lowers costs.
One of the biggest benefits of integrated care is that it provides better access to services. Under an integrated healthcare model, a patient that needs mental health services can quickly get a referral from their PCP and see someone with little delay. Without the silo of physical health and behavioral health being treated differently, patients can get the care they need. Plus, with many integrated healthcare providers offering virtual healthcare services and telemedicine (see more VBP blogs on that topic), healthcare services are more accessible than they’ve ever been.
How Integrated Care and Value-Based Payments Are Intertwined
So, we know that physical health and behavioral health are closely connected and that integrated healthcare is the best way to address that. But how do we get plans and providers to buy in? That is where value-based payments come into the picture.
Value-based payments have always been an important lever in supporting the transformation of care delivery, but it is especially important for the move to integrated health care. That is because VBP can better support services and care delivery models that are not adequately or typically reimbursed through FFS arrangements.
It’s important to consider that integrated health care takes a lot of collaboration and will not happen overnight. It requires careful planning and investment and quite frankly, under a traditional FFS model, providers have no incentive to undertake the costly and time-consuming initiative.
However, through value-based payments, providers are rewarded based on the health outcomes of a given population. Integrated care can lead to better health outcomes, so by tying financial incentives to the quality of care and outcomes, it incentivizes providers to coordinate and collaborate under an integrated healthcare model.
This is something that states like California and New York are exploring by implementing integrated care plans incentivized by value-based payments. Pennsylvania is also carefully considering adopting an integrated healthcare program. As the incentives of utilizing value-based payments to drive the adoption of integrated care continue, expect even more states to get on board.
We know the benefits of integrated care and the benefit that value-based payments provide in incentivizing the transformation. However, as more states begin shifting to an integrated care model under VBP, it is important that stakeholders are considered throughout the entire process. Careful planning needs to be undertaken to ensure that the needs of consumers are put at the forefront, which means actively engaging them during the planning process. States need to consider carefully designed pilots as they create incentives for moving toward integration. While integrated care is certainly something that should continue to be adopted, doing it right will ensure that consumers get the most benefit.
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About the Author
Fady Sahhar brings over 30 years of senior management experience working with major multinational companies including Sara Lee, Mobil Oil, Tenneco Packaging, Pactiv, Progressive Insurance, Transitions Optical, PPG Industries and Essilor (France).
His corporate responsibilities included new product development, strategic planning, marketing management, and global sales. He has developed a number of global communications networks, launched products in over 45 countries, and managed a number of branded patented products.
About the Co-Author
Mandy Sahhar provides experience in digital marketing, event management, and business development. Her background has allowed her to get in on the ground floor of marketing efforts including website design, content marketing, and trade show planning. Through her modern approach, she focuses on bringing businesses into the new digital age of marketing through unique approaches and focused content creation. With a passion for communications, she can bring a fresh perspective to an ever-changing industry. Mandy has an MBA with a marketing concentration from Canisius College.