The approach also was associated with decreased costs over a period of 4 years.
Barriers to adoption of such integrated care models include a shrinking proportion of psychiatrists compared with the growing mental health workforce; financing (the disconnected medical and psychiatric payment systems for psychiatrists and other specialists); the fact that electronic medical records systems are not well established in psychiatry, which raises operational and confidentiality issues; and the discrimination against psychiatric care in many insurance plans.
"We need to have systems that are much more granular, but the reality is that the data that drive payment systems, and the data that are going to be associated with quality metrics for both individual physicians and systems as a whole, will come out of these systems. If we remain on the outside of them, it will marginalize and put the patients we care for at serious risk," Dr. Summergrad said.
Overcoming the barriers will require research regarding medically comorbid illness and models of care. In addition, increased training and education for all physicians, including those currently in practice and those in training, and electronic medical records that are well adapted for psychiatric practice are needed, he said.
Dr. Summergrad reported having done nonpromotional speaking for CME Outfitters.