Tufts Health Plan Funds Three Initiatives for Improving Integrated Behavioral Health in Rhode Island

WATERTOWN, MA – With a commitment to integrated behavioral health and the importance of the patient-centered medical home model for primary care in Rhode Island, Tufts Health Plan has funded three projects in the state. The projects, which will be implemented in 2015, are designed to test strategies for increasing patient access to behavioral health services within primary care settings.

The patient-centered medical home is a model for providing comprehensive primary health care for children, youth and adults. It integrates patients as active participants in their health and utilizes a physician-led medical team approach, which takes place at a medical office. All aspects of a patient’s care are coordinated, increasing the use of preventive care and regular screenings and supporting people with diabetes, depression and other chronic diseases.

“Research supports that patients will experience better access to mental health services if offered in a primary care setting,” said Dr. David Brumley, senior medical director, Tufts Health Plan. “Our hope is that these projects will help strengthen how primary care practices can improve their abilities to respond to patients’ needs for behavioral health interventions and address some of the significant issues facing Rhode Island residents, such as substance abuse, depression and anxiety disorders.

To support the evolution and effectiveness of the patient-centered medical home, Tufts Health Plan funded the following three projects designed by the Care Transformation Collaborative of Rhode Island, the umbrella organization of patient-centered medical homes (formerly known as the Rhode Island Chronic Care Sustainability Initiative (CSI-RI)):

  • Implementing education and training to improve the capacity of primary care staff to provide integrated behavioral health services
  • Expanding web-based referrals and care coordination to improve Rhode Island’s behavioral health referral network for primary care providers to refer patients for behavioral health spet or addiction disorder spet appointments
  • Accessing technology tools for behavior change to improve patient engagement in making healthier lifestyle choices through interactive website applications

“Tufts Health Plan is an important partner in advancing these projects that have been designed to improve integrated behavioral health as part of patient-centered medical homes,” said Debra Hurwitz, MBA, BSN, RN, co-director, Care Transformation Collaborative of Rhode Island. “The projects address the needs of medical practices around how they can more effectively work with patients in the primary care setting for such things as mental health care, substance abuse and unhealthy lifestyles.”

The projects were created based on findings from a recent survey conducted by the Care Transformation Collaborative of Rhode Island to assess behavioral health needs at primary care practices in Rhode Island that have implemented patient-centered medical homes.

The grants address the Office of the Health Insurance Commissioner’s requirement for major commercial health insurance plans to comply with a set of four Affordability Standards aimed at improving the affordability of health care in Rhode Island. Health insurance plans are required to pay a portion of medical costs in primary care as a “non-fee for service” offering.

About the Care Transformation Collaborative of Rhode Island
The Care Transformation Collaborative of Rhode Island (CTC), formerly the Rhode Island Chronic Care Sustainability Initiative, is working with all major health care stakeholders to transform primary care in Rhode Island. Co-convened by the Office of the Health Insurance Commissioner and the Executive Office of Health and Human Services, CTC promotes the patient-centered medical home, a model of primary care that is patient-focused, coordinated, accessible and team-based. The model focuses on prevention, wellness and appropriate treatment, which will lead to improved care, lower costs and better health outcomes for Rhode Island. For more information, visit www.pcmhri.org.

About Tufts Health Plan
A nonprofit organization founded in 1979, Tufts Health Plan is nationally recognized for its commitment to providing innovative, high-quality health care coverage. Touching the lives of more than one million members, Tufts Health Plan serves members in Massachusetts and Rhode Island, offering coverage across the life span regardless of age or circumstance.

Tufts Health Plan is ranked the #1 private health plan in the country.* Its Medicaid plan is also ranked #1 in the country.** Its Tufts Medicare Preferred HMO and Senior Care Options plans earned a 4.5 Star rating – based on a five star rating – from the Centers for Medicare and Medicaid Services for 2015.

Tufts Health Plan is also currently ranked for “highest member satisfaction among commercial health plans in the New England region” by J.D. Power.

For more information visit us at TuftsHealthPlan.com.

Leave a comment

Avatar About the Author: The Rhode Island Small Business Journal is a printed monthly magazine and an online resource for the aspiring and start-up entrepreneur and small business owner.

previous arrow
next arrow