UVM Health Network launches collaborative care model

Published: Dec. 7, 2022 at 2:01 PM EST
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BURLINGTON, Vt. (WCAX) - The UVM Health Network has implemented a new plan model to transform primary care practices into a one-stop-shop that integrates physical and mental health treatment.

Vermonters can now walk into any one of four clinics near Middlebury and seven clinics in the Burlington area and the physicians will collaborate as a team to treat the whole patient.

“It allows the psychiatrist to focus on what we need the psychiatrist to focus on and it allows the primary care provider to treat what they very capably can treat,” said the Maureen Leahy, the network’s director of neurology and psychiatry. She says what would have been a pricey an hour-long appointment with a psychiatrist after sitting on a waitlist for months, is now streamlined into a 15-minute consultation between your PCP and an in-house mental health professional in the same location. “It’s not just an hour, it’s the initial hour and then subsequent follow-up visits, so it’s really consolidating the expertise needed for the intervention.”

And it eases pressure on the psychiatry backlog. The network is hiring six to seven psychiatrists to eventually cover all 37 PCP sites. Each will serve the entire population of multiple practices and bounce between clinics. Meanwhile, 33 to 35 behavioral health care managers will -- for the most part -- stay on-site to consult and educate PCPs when patients require mental health support. Behavioral health care managers can be social workers, licensed clinical mental health clinicians, nurses, or even family therapists. They just need training in psychology to fit the criteria.

In other words, your PCP and a behavioral health care manager are employees at the same clinic and working in tandem. “The primary care provider sees Sara in the hallway and says, ‘Hey, John came in and this thing that we tried isn’t working. What do we do next?’” Leahy said.

“One of the best examples of that may be for a major depressive episode, it’s very common for someone to first present in primary care for this, and a primary care provider can help connect to a behavioral health care manager in the practice who can set them up with cognitive behavioral therapy and start a first-line medication like a serotonin reuptake inhibitor,” said Dr. Sara Pawlowski, a UVM Health Network psychiatrist.

It means that psychiatrists -- who are in short supply -- can prioritize more acute, complicated cases. The percentage of patients who aren’t improving under the PCP’s plan or have coexisting conditions. “And what that does is over time kind of free up a psychiatrist to see people who really need to be seen and would benefit from that specialty,” Pawlowski said.

Leahy says the program is lucrative because of the evolving shift from a fee-for-service payment model to a value-based payment model. The philosophy is to treat the entire community.

“When I think about the patients and the families that are struggling with this, to be able to say to them, ‘We have people right here who can help you.’ To me, that’s really powerful,” she said.

The UVM Health Network has posted positions to expand this program to central Vermont. Clinics across New York will also eventually adopt this model.

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