Intermountain Healthcare study shows integrating mental and physical health services leads to better outcomes, lower costs

10-year inquiry led by Intermountain's Chief Quality Officer Brent James, MD, is one of the largest of its kind
By Bernie Monegain
11:22 AM

An Intermountain Healthcare study conducted at 27 team-based medical practices and 75 traditional practices revealed that delivering integrated mental and physical healthcare in team-based primary care settings yields better results for patients and also reduces the rates healthcare utilization and lowers cost.

The research, which tracked 113,452 adult patients who received care from 2003 through 2013 in 113 primary care practices Intermountain Healthcare, is published in the Journal of the American Medical Association, accompanied by an editorial in JAMA that heralded the benefits of integrated mental health care.

The decade-long study – one of the largest of its kind, according to Intermountain – was led by Brent James, MD, the health systems's chief quality officer and executive director of the Intermountain Institute for Healthcare Delivery Research.

"For patients, the bottom line of the study is that getting care in a team-based setting where medical providers work hand-in-hand with mental health professionals results in higher screening rates, more proactive treatment, and better clinical outcomes for complex chronic disease," Intermountain Healthcare scientist Brenda Reiss-Brennan, one of the study's authors, said in JAMA.

"Team-based care means providers work together to care for all chronic conditions, mental and physical," she added. "At Intermountain, 80 percent of mental health services are provided by primary care physicians, and when they're supported by an integrated team, both they and their patients benefit."

Other key findings of the study:

  • A higher rate of patients in team-based practices were screened for depression that allowed care providers to provide medical and behavioral interventions earlier – compared to patients in traditional practices. Forty-six 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.
  • Also, 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.

Before the study, limited evidence was available to support the effectiveness of a care model that integrated mental health providers with primary care teams, Intermountain researchers note.

"The study reinforces the value of coordinated team relationships within a delivery system and the importance of integrating physical and mental health care," Reiss-Brennan. "The study provides further evidence – from a mental health perspective – of Intermountain Healthcare's hypothesis that better care costs less."

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