Training the Healthcare Workforce for Integrated Care
Most healthcare providers agree that mental health affects physical health and vice versa. However, integrating the two is not easy. Providers aren’t trained to address both the mind and the body in one setting. As we transition towards value-based reimbursement, there’s a greater incentive to improve quality for patients. The Center of Excellence for Integrated Care (COE) is an example of a creative approach to improving patient outcomes.
The imminent changes to our healthcare system will result in a workforce that operates differently—and that’s where COE steps in. Housed in the NCFAHP, this small team provides the tools and training for integrating mental and physical health. “And we have our eyes on oral health specialists and pharmacists too.” says Associate Director Christine Borst.
The COE team works in a broad range of settings, and not just traditional healthcare sites. “North Carolina is one of the most diverse states in the nation when it comes to putting teams together to meet the patient where they seek services,” says Director Cathy Hudgins, “This can be a school-based clinic, a mental health or substance abuse clinic, homeless shelters, migrant worker camps and church basements.”
COE breaks down the cultural and educational barriers between health sectors. This type of workforce development, dubbed cross-training, is crucial to better patient outcomes. “It’s been exciting to work with universities,” said Borst, “Conducting trainings early on is really helpful for developing that multidisciplinary lens.”
In a healthcare practice with established workflows, cross-training requires a colossal team effort. “We work with everyone in the office, from the front desk ‘eyes and ears’ of the clinic, to the physicians and therapists in the back,” said Borst, “Regardless of what kind of specialist you are, it’s essential to work together as a team and develop a mindset of integration.”
Every care site is different. Some have a behavioral health therapist in-house; others have close connections to one. Some have no partnerships or experience with behavioral health. Borst gave the example of smoking cessation or diabetes diagnosis. “These issues really require a behavioral health intervention,” she said, “And not every clinic has the resources to provide that.” Tailoring training to meet the needs of a care setting is part of COE’s work. Every practice and every community has its assets, and COE works to create partnerships around those assets.
The biggest hurdle for integrating care is payment reform. “Everyone wants to know how to pay for it,” said Borst. COE provides some direction on navigating the billing process, but it will take policy reform to dictate how behavioral health integration will be properly reimbursed.
Effective workforce training to integrate the siloes of care is an important step towards fully implementing value-based care. “There’s a method to our madness,” Borst said, “Laying a strong foundation for a multidisciplinary approach is the first step.”