Integrating Behavioral Health into Pediatric Primary Care: Implications for Provider Time and Cost

Area of Science:

• Primary Care Integration
• Behavioral Health Services
• Health Services Research

Background:

• Integrating behavioral health consultants (BHCs) into primary care settings is linked to better patient outcomes and provider satisfaction.
• Operational feasibility, particularly regarding time and cost, remains a significant barrier to widespread BHC implementation.

Purpose of the Study:

• To evaluate the operational impact of an on-site behavioral health consultant (BHC) in a pediatric primary care practice.
• To compare provider time spent, patient volume, and revenue on days with and without an on-site BHC.

Main Methods:

• A 10-day comparative study was conducted in a rural pediatric primary care practice.
• Data collected included patient direct care time stamps, provider-reported issues, and billing/reimbursement records.
• Participants included five pediatric primary care providers (PCPs) and two BHCs serving 668 pediatric patients.

Main Results:

• On days with a BHC, PCPs spent an average of 2 fewer minutes per patient.
• Patient volume increased by 42% when a BHC was available.
• Revenue collected was $1142 higher on days with an on-site BHC.

Conclusions:

• The presence of a BHC significantly enhances operational efficiency and financial viability in primary care.
• Findings support the feasibility of hiring behavioral health professionals within fee-for-service models.
• Results also highlight the value of collaborative practice and bundled care systems.