VA Mental Health Initiative Linked to Improved Access to Care

Addition of mental health specialists at primary care clinics increased utilization but also cost
psychiatrist and patient
psychiatrist and patient

MONDAY, Aug. 19, 2019 (HealthDay News) -- Adding mental health specialists, care managers, or both to primary care clinics for veterans results in more visits for both mental health and primary care but also increases the average yearly cost per patient, according to a report published online Aug. 9 in Health Affairs.

Lucinda B. Leung, Ph.D., of the University of California Los Angeles David Geffen School of Medicine, and colleagues examined data from a total of 5,377,093 patients who received primary care at any of the 396 VA clinics that provided mental health services under the Primary Care-Mental Health Integration (PC-MHI) initiative, as well as 1.9 million patients who were assigned to clinics that did not provide mental health services.

After adjusting for clinic, year, and patient characteristics, the researchers found that each percentage point increase in patients who received care from a PC-MHI provider resulted in an 11 percent increase in the average total of mental health visits, a 40 percent increase in primary care visits, and a 9 percent increase in average yearly cost per patient. In patients diagnosed with depression or anxiety, there was a significant reduction in non-mental health specialty visits, a significant increase in telephone visits, and a nonsignificant reduction in average total costs.

"The PC-MHI and Patient Aligned Care Team initiatives appear to have met their intended aim of expanding prompt access to evidence-based mental health care for primary care patients overall," the authors write.

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