Cigna Behavioral Health Practitioner Connection – THE COORDINATION OF BEHAVIORAL CARE WITH PRIMARY CARE

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CBH Practitioner Connection
Volume XXV, 1st Quarter

The right help at the right time!

THE COORDINATION OF BEHAVIORAL CARE WITH PRIMARY CARE

It is the policy of Cigna, and a requirement of our customers' health plans, that behavioral health services must be closely coordinated with general medical care. The results of the 2007 Practitioner Treatment Record Reviews reveal an opportunity for improving coordination of care between behavioral and medical practitioners.

Item #22 on the record review tool: “The record reflects attempts to coordinate behavioral care with the primary care physician at any time during treatment when coordination of care is indicated. (N/A for the following types of cases: Family problems, marital therapy, adjustment disorder.)”

Examples of Compliance
The record documented that:
1. The participant refused to give consent to communicate with their PCP.
2. The participant does not have a PCP and the behavioral health practitioner encouraged the participant to get a PCP.
3. The practitioner attempted to communicate verbally or in writing with the PCP.

Results for Item #22 in 2007 (Goal = 80%)
MDs/DOs: 81.5% (110/135)
PhDs: 57.5% (65/113)
ARNPs: 59.4% (60/101)
Master’s: 79.3% (195/246)
Total: 72.3% (430 /595)

Only psychiatrists met the 80 percent compliance goal. Possible contributing factors to low compliance may be seen in the 2006 Practitioner Satisfaction Survey that asked behavioral practitioners the following question: “If there are problems in obtaining information from the Primary Care Physician, which of the following were contributing factors? (Check all that apply):”

Results	MD	PhD	ARNP	MAs	Total
Number that responded to survey	174	446	36	1133	1789
Lack of response from PCP	27.0%	39.0%	33.3%	44.7%	41.4%
Patient's concern about confidentiality	20.7%	22.9%	33.3%	21.4%	22.0%
Behavioral practitioner concern about confidentiality	9.8%	5.8%	8.3	4.4%	5.4
PCP's concern about confidentiality	8.0%	2.2%	8.3	3.3%	3.6%

41.4% of practitioners attributed problems in obtaining information from the PCP to a lack of response from the PCP. Physicians indicated the least difficulty (27%) in obtaining a response from the PCP, suggesting that PCPs may be more likely to respond to requests for information from other physicians.

Information on Cigna's expectations for continuity and coordination of care is contained in the Medical Management Program guide, available by free download on our Web site. The guide is updated quarterly, so check frequently for updates.