In June the Blue Cross Blue Shield (BCBS) of Massachusetts Foundation released a report prepared by John Snow, Inc. called Fostering Effective Integration of Behavioral Health and Primary Care in Massachusetts: An Evaluation, which highlighted the importance of Integrated behavioral health (IBH). Vinfen was one of eight organizations selected for the initiative and the publication featured Vinfen’s utilization of a smart phone application designed in partnership with Wellframe.
BCBS Massachusetts Foundation implemented Fostering Effective Integration (FEI) in 2016 as a three-year study to learn more about increasing access to integrated health and primary care services. The Foundation selected and provided funding for eight organizations across the state to expand their experience with IBH to other populations or settings. Each of these organizations already had substantial integrated behavioral health experience with their population base. IBH is a person-centered approach to achieving wellness by the collaboration of both behavioral health and medical providers. This includes integrating mental health, substance use, and primary care services into one healthcare system for those with multiple healthcare needs.
At the conclusion of the study, FEI hoped for findings regarding if IBH service expansion improved access to care, the assessment of both facilitating and challenging factors of the implementation of IBH, if health outcomes improved with people engaged with IBH services, information on costs associated with IBH, and addressing the sustainability of IBH services.
The primary focus of this initiative was learning more about IBH and the potential for expansion to new settings or populations that experienced successful results from the study. Vinfen specifically worked with a population of people receiving services that experience severe mental health challenges and are living either in group homes or independently. These people have access to day programs and consistent support from community health care workers who coordinate needed services.
During this study, Vinfen also promoted using a smart phone application that focuses on providing a person-centered experience regarding one’s wellness. The app is able to assist a person with transitions of care while maintaining overall health and wellness, and care plans can be customized, which encourages patients to stay engaged regarding communication with providers. During a six-month period, Vinfen observed how often a person receiving services used the app. 61% of people used the app especially regarding reminders of medication and physical activity, educational surveys, and communication via text messaging with Vinfen direct care staff.
Vinfen selected the Healthy Lives 5 (HL5A Scale) as their evaluation method during the initiative, which evaluated a patient’s status in five categories. These include physical and behavioral functioning, proper use of health services, access to services and provider relationships, basic physical, economic, and social needs being met, and diligent self-care. This scale was developed at The Brookline Center for Community Mental Health.
As a result of the FEI initiative over the three year timeline, there was broader access to IBH by populations served within the eight organizations, with the overall improvement of patient outcomes. All organizations expressed a desire to continue their IBH efforts, recognizing the immense potential of how IBH can help people. “Perhaps the most important finding related to the FEI is that all eight grantees have plans for sustaining their IBH services. This means that each grantee believes IBH works in their organization and benefits their patients,” BCBS Foundation Massachusetts shared. Lessons on costs associated with IBH were learned as well as having concrete data tracked by organizations to refer to when exploring IBH further in the Commonwealth of Massachusetts.