Montefiore Medical Center has been selected to receive a $5.6 million Health Care Innovation Award from the Center for Medicare & Medicaid Services (CMS) to develop the Bronx Behavioral Health Integration Project (Bronx-BHIP), a program that will integrate behavioral health care for children and adults in primary care settings. 

Montefiore’s Bronx-BHIP is designed to increase the availability of vital behavioral services and test an innovative reimbursement methodology that has the potential of generating health system savings. The program is the first time the integrated behavioral and medical care model will be tested on such a large scale at an academic medical center serving a safety-net population. 

“The Bronx-BHIP program is unique in that it will be implemented across the entire age spectrum. This is especially important for children because when behavioral health issues are identified and managed early in life, there is enormous impact on the future of their well-being,” said Andrew D. Racine, M.D., Ph.D., senior vice president and chief medical officer, Montefiore. “We are delighted that CMMI believes that Montefiore is a leader in changing the paradigm of traditional fee-for-service health care to a model that emphasizes both quality care and cost effectiveness." 

Bronx-BHIP focuses on identifying and providing care to individuals of all ages for a broad range of behavioral health conditions in primary care settings. The integrated care model will administer evidence-based, age-appropriate behavioral health screening and other services to Medicare, Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries, as well as members of several health plans, in selected Montefiore primary care practices. There are also web-based video components to the program to facilitate access to care.

Patients with behavioral disorders will be treated by a team that includes a psychiatrist, psychologist or social worker and a care manager, who will collaborate with primary care providers to provide screenings, assessments, treatment and other patient follow-up.

“Traditional models of health care typically address behavioral and physical illnesses separately,” said Henry Chung, M.D., chief medical officer, Montefiore’s Care Management Program and executive director of Bronx-BHIP. “By increasing access to behavioral services in the same setting where patients receive most of their medical care, we can proactively monitor both behavioral and physical health conditions; we can treat the 'whole person.' When behavioral health care needs are not addressed, things like adherence to treatment regimens for their medical conditions and attendance at follow-up visits may be compromised, resulting in poor outcomes and increased utilization of services, including emergency room visits and hospitalizations.”

The reimbursement methodology that Bronx-BHIP will test is designed to help accelerate adoption of the program and support program sustainability by paying providers a fee for the early identification of behavioral health issues and the continued treatment and care coordination of patients while being held to a number of quality indicators. The long term goal is to demonstrate that patients with behavioral health disorders can be successfully treated in a primary care setting at a lower cost to the health care system.

The Health Care Innovation Awards program, part of the Affordable Care Act, is intended to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and CHIP, particularly those with the greatest health care needs. The goal is to also lower the nation’s overall spending on health care.