MaineHealth, the nonprofit integrated health system, which includes MBH, found its champion for integrating behavioral health into primary care in Neil Korsen, MD, medical director of MaineHealth's mental health integration program.
"There is good evidence that the referral process from primary care to specialty mental health care often breaks down," says Korsen. "The integrated clinician is a bridge that can help a patient who is ultimately going to need longer term treatment than we tend to provide in primary care."
Primary care physicians are used to seeing patients present with mild depression or anxiety in their offices, and that is one audience this integration initiative can help. Patients with diabetes, chronic pain, obesity, or who are abusing drugs and/or alcohol are the other populations that Korsen and others believe can be helped with behavioral health integration.
"We have demonstrated in almost every practice… that a half-time LCSW can be sustained with a modest level of productivity," says Korsen, who estimates nearly 30 behavioral health clinicians, mainly LCSWs, are now working across 40 MaineHealth primary care practices.
Korsen says the practices are breaking even financially, despite a recent media report about high executive pay in the wake of $2 million in cuts at a MaineHealth affiliate.
Dennis King, CEO of Maine Mental Health Partners, which has merged into Maine Behavioral Healthcare, attributes the break-even status to intricate planning and knowledge of proper use of behavior codes. Reimbursement is still a major challenge, but so is caring for a patient with a fragmented system.