Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Maximizing care amidst provider shortages: the power of measurement-based care

Tom Zaubler, MD
Policy
September 18, 2023
Share
Tweet
Share

Since the pandemic, the shortage of behavioral health professionals has become more dire as the need for more comprehensive mental health care has increased. As of March 2023, 160 million Americans lived in areas with mental health professional shortages. 55% of counties in the U.S. have no psychiatrists, and 77% report a severe shortage.

In some states, such as Maine, there was a 50% drop in the number of psychiatrists from 2015 to 2020, leading to wait times of up to 18 months to access psychiatric care. Moreover, 70% of psychiatrists are 50 years old or older. By 2025, demand for psychiatrists will outstrip supply by 25%.

The toll that psychiatric illness takes is substantial. Depression is the leading cause of disability in the world. Medical costs for treating patients with chronic medical disorders and co-occurring psychiatric disorders such as depression are two to four times higher than in those without psychiatric disorders.

Nearly half the population in the U.S. report recent symptoms of anxiety and depression. The annual number of deaths by suicide is 48,000, and overdose deaths exceed 100,000. Among the 20% of the U.S. population that are the highest utilizers of medical care – accounting for 80% of all health care costs – 60% to 80% have an underlying psychiatric disorder that drives increased utilization. Despite the high prevalence of psychiatric illness and costs associated with untreated psychiatric illness, 60% of those with a psychiatric disorder and 90% of those with substance use do not receive any psychiatric treatment. It’s not only the stigma of receiving treatment or a lack of resources available but an unreliable intake system to identify and support those who need the most help.

We live in an era where physical health providers are overwhelmed with requests from patients, lacking many of the tools and training needed to address the surge. And simply collecting written questionnaires on a patient’s mental health is not enough. Integrated behavioral health care models, where behavioral and physical health providers work together to treat patients, can address this growing issue. But with limited resources and high demand, delivering effective, integrated behavioral health care at such a large scale is challenging.

In response to this growing need, measurement-based, population-focused models of care combined with the thoughtful utilization of digital solutions has emerged as an effective approach that can help deliver integrated care at scale despite limited resources.

What is measurement-based, population-focused care?

Measurement-based and population-focused care, a critical part of integrated care models like collaborative care, is an evidence-based health care approach where treatment decisions are guided by systematic measurement of patient-reported symptoms, functioning, and overall well-being.

Typically, measurement-based care (MBC) includes standardized questionnaires (to assess symptom severity, progress, etc.), data collection, and provider analysis of the data to make informed treatment decisions and continuously adjust a treatment plan based on the patient’s evolving needs. This health care approach allows providers to offer more effective and personalized care based on objective information collection and assessment.

MBC, traditionally used to collect and assess physical health metrics (blood sugar, weight, etc.), is essential for treating patients holistically — taking into account both their physical and behavioral health. For patients needing behavioral health support, MBC can help objectively track and assess a patient’s symptoms, which can often be subjective and highly variable over long periods. With MBC, health care providers can monitor a patient’s mental health status — whether it’s stable, improving, or declining — and address it accordingly.

Aside from the efficiency that MBC can provide, this type of clinical approach can also help bridge other, more interpersonal gaps in the health care system. If executed well, ongoing patient monitoring can inform highly personalized treatment plans and improve patient and provider communication, allowing patients a structured channel for sharing their experiences with mental health without stigma or shame. Likewise, MBC can be used to help bolster patient engagement. The self-reported methods of MBC can encourage patients to take a more active role in their treatment plan and diagnosis, which can be empowering.

Integrated care models are focused on treating large populations while relying on fewer resources. Psychiatrists that participate in these integrated care models will not consult with patients directly. Instead, they provide oversight of large caseloads of patients managed by behavioral health clinicians working in the practices alongside the non-psychiatric attending physicians (e.g., primary care physicians).

MBC and population-focused integrated care models can bring an actionable, data-driven approach to supporting behavioral health while substantially increasing access to behavioral care holistically interwoven with patients’ overarching medical needs. However, it’s incredibly challenging to execute this strategy successfully without the right technology.

ADVERTISEMENT

How can technology advance measurement-based care?

One of the biggest hurdles to using measurement-based care is having the right technology to deploy and scale it. Without technology, health care providers can struggle with administering routine assessments, or receiving unbiased patient information (due to the lessened but still present stigma around mental health) among other administrative burdens. With technology, health care providers can work more efficiently and more cost-effectively by sending remote questionnaires – clinical assessments like PHQ-9 and GAD-7 – via desktop or mobile, so providers and patients aren’t limited to in-person assessments, which can take up valuable appointment time.

Providers can set up custom notifications that alert health care providers, directly in the EHR, when a patient’s data indicates a significant change or deterioration to help ensure timely intervention if necessary. Technology helps health providers make the most out of MBC — helping to risk-stratify populations, deliver timely interventions, and even allow health care providers to be proactive in their care, saving costs and preventing behavioral health crises.

Measurement-based care — with the help of technology — embodies a commitment to evidence-based, patient-centered care, and it holds the potential to revolutionize how we understand, manage, and treat behavioral health conditions. The deployment of MBC using robust, secure technology has the power to create a brighter, healthier future for everyone.

Tom Zaubler is a psychiatrist and physician executive.

Prev

Unthinkable choices in childbirth emergencies

September 18, 2023 Kevin 0
…
Next

Ketamine for mental health conditions: What every primary care physician needs to know

September 18, 2023 Kevin 0
…

Tagged as: Psychiatry

Post navigation

< Previous Post
Unthinkable choices in childbirth emergencies
Next Post >
Ketamine for mental health conditions: What every primary care physician needs to know

ADVERTISEMENT

Related Posts

  • Primary Care First: CMS develops a value-based primary care program for independent practices

    Robert Colton, MD
  • The expanding role of specialists in value-based care

    Martin Lustick, MD
  • How social media can help or hurt your health care career

    Health eCareers
  • Behavioral health providers face challenges in value-based care

    Martin Lustick, MD
  • To “fix” health care delivery, turn to a value-based health care system

    David Bernstein, MD, MBA
  • Direct primary care is an answer to volume-based insurance reimbursement models

    Troy A. Burns, MD

More in Policy

  • Online eye exams spark legal battle over health care access

    Joshua Windham, JD and Daryl James
  • The One Big Beautiful Bill and the fragile heart of rural health care

    Holland Haynie, MD
  • Why health care leaders fail at execution—and how to fix it

    Dave Cummings, RN
  • Healing the doctor-patient relationship by attacking administrative inefficiencies

    Allen Fredrickson
  • The hidden health risks in the One Big Beautiful Bill Act

    Trevor Lyford, MPH
  • The CDC’s restructuring: Where is the voice of health care in the room?

    Tarek Khrisat, MD
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...