Virtual Behavioral Health Integration (VBHI)

The primary objective is to evaluate the effectiveness of the virtual behavioral health integration (VBHI) program compared to usual care, on reducing the total cost of care reimbursed from Medicare and value-based contracts within 90 days of a patient's primary care visit.

To enhance the care of patients seen in the primary care setting, Atrium Health has designed a virtual behavioral health integration program. A behavioral health care team comprised of licensed clinicians (Behavioral Health Professionals), health coaches, a consulting psychiatric pharmacist and psychiatric providers follow patients for up to 3 months or more depending on patient need after their primary care office visit. This virtual behavioral health integration (VBHI) program is currently available in 36 Atrium Health primary care practices providing support to over 200 providers and medical residents. The Behavioral health Service line is expanding the program to additional primary care practices. Atrium Health and the Carolinas Physician Alliance is interested in evaluating the effectiveness of the program on reducing the total cost of care.

All patients who meet eligibility criteria at sites where the virtual behavioral health program is offered will be considered exposed to the intervention.

All patients who meet eligibility criteria at sites where the virtual behavioral health program is not offered will be considered exposed to usual care.

The virtual behavioral health integration program, implemented in primary care settings, is a structured mental illness treatment program that includes both behavioral treatment and counseling components aimed at reducing cost of care, developing and sustaining adaptive coping strategies, and improving short term acute care utilization.

Does a patient have an inpatient, observation, or emergency department encounter after their primary care visit

Inclusion Criteria: 18 years of age or older Primary care office visit Have a Patient Health Questionnaire-9 (PHQ-9) and overall score >=10 or Question 9 >0 Medicare or value-based contract associated with a patient in the past year at the time of the primary care visit. Exclusion Criteria: A patient will contribute to the analysis once using their initial enrollment to either arm of the study. No insurance claim for the index primary care visit in the data warehouse upon evaluation.