Integrating mental and physical health through primary care teams results in better clinical outcomes and lower costs

https://goo.gl/a2rwko

The 10-year study — which is one of the largest studies of its kind — shows the benefits of care provided by team-based providers in an integrated delivery system. The study, which was conducted by Intermountain Healthcare researchers, measured 113,452 adult patients who received care from 2003 through 2013 in 113 primary care practices at Intermountain, including 27 team-based medical practices and 75 traditional practices. 

What are the results of the study (and the clinical benefits of team-based care)?

  • A dramatically higher rate of patients in team-based practices were screened for depression — which allowed care providers to provide medical and behavioral interventions earlier — compared to patients in traditional practices. 46.1 percent of patients in team-based practices were diagnosed with active depression compared to 24.1 percent in traditional practices.

  • 24.6 percent of patients in team-based practices adhered to diabetes care protocols, including regular blood glucose testing, compared to 19.5 percent in traditional practices — which demonstrated how well patients engaged with care teams in working together to manage their health.

  • 48.4 percent of patients in team-based practices had a documented self-care plan to help them manage their health conditions, compared to 8.7 percent in traditional practices.

  • 85.0 percent of patients in team-based practices had controlled high blood pressure, compared to 97.7 percent in traditional practices (although the care teams involved in the study didn’t focus on blood pressure like they did on depression and diabetes).

Patients in team-based medical practices also used fewer healthcare services and had lower total costs, according to the study. Data showed that per 100 person years:

  • The rate of emergency room visits was 18.1 for patients in team-based practices versus 23.5 visits for patients in traditional practices, which is a reduction of 23.0 percent.
  • The rate of hospital admissions was 9.5 for patients in team-based practices versus 10.6 in traditional practices, which is a reduction of 10.6 percent.
  • The number of primary care physician encounters was 232.8 for patients in team-based practices versus 250.4 for patients in traditional practices, which is a reduction of 7.0 percent.
  • Payments to providers were $3,400 for patients in team-based practices versus $3,515 for patients in traditional practices, which is a savings of 3.3 percent. The payments were less than the investment costs Intermountain incurred in creating the team-based practice model.