The Keys to Primary Care and Behavioral Health Integration

Today, many traditional care models remain siloed and fall short of whole-person-centered care that addresses both behavioral and physical health conditions – and how they impact each other. Emerging healthcare models, including virtual care and the expansion of digital health tools, seek to integrate value, quality, and access while keeping the patient journey and experience top-of-mind.

In this piece, I’ll share insights on why Behavioral Health Integration (BHI) is central to patient and provider satisfaction, the potential challenges and benefits of this approach, and what BHI looks like in practice.

The role of behavioral health in primary care

Behavioral health factors have a strong influence on patient morbidity and mortality.

In fact, according to the American Academy of Family Physicians, as many as 75% of primary care visits include mental or behavioral health components. And, 67% of adults with a behavioral health condition do not receive appropriate treatment.

In the face of nationwide psychiatrist shortages, primary care providers (PCPs) are often positioned as the first-line of behavioral health care for their patients. However, while PCPs often want to know more about behavioral health and how to care for their patients, they don’t always have the time or specialization to treat more complex cases.

That’s because treating a behavioral health condition doesn’t always have a clear or obvious path for medication and treatment. However, by leveraging a virtual behavioral health solution, PCPs can ensure their patients are getting the help they need and healthcare organizations can ensure financially sustainable delivery of behavioral health services.

The financial benefits of Behavioral Health Integration

According to a Briefing Series on the Role of Psychology in Health Care by the American Psychological Association, the interconnection of behavioral health and physical health can have a profound impact on total cost of care:

  • Behavioral health conditions like anxiety and depression can worsen chronic conditions like cardiovascular disease, asthma, diabetes, and cancer.
  • Research shows treatment of behavioral health conditions in primary care settings offset costs by 20-40%. 
  • Research also shows fewer hospitalizations that result in significant cost reductions for patients with comorbidities and improvement in treatment adherence, translating to $105 billion in annual avoidable health care costs.

To add to these numbers, in a behavioral health analysis by Evernorth Health Services, treating behavioral health conditions in outpatient care is directly tied with a reduction in medical and pharmacy costs — with savings up to $2,565 per person over 15 months following a diagnosis and up to $3,321 per person over 27 months following a diagnosis.

These numbers show us that primary care providers shouldn’t face the burden of providing behavioral health services alone. And they don’t have to. With the help of a behavioral health specialist, their organizations can generate savings and their patients can experience superior outcomes.

Challenges and solutions organizations may face when implementing collaborative care

While behavioral health integration delivers clear benefits for your patients, care team, and PCPs, achieving it isn’t without its challenges. Some of the most common challenges we’ve heard from healthcare organizations include:

  1. Long wait times for behavioral health providers: Providing timely access to care for mid-to-high acuity behavioral health conditions can be challenging. For example, if a patient needs medication management from a psychiatrist, wait times can often be too long. However, if a provider is integrated into a practice, seeing a SUD therapist, for example, may be quicker.
  2. Greater level of assessment required: While PCPs take on the majority of behavioral health patients, sometimes the level of assessment is greater than what they can provide. While there’s no easy button, integrated care, even at a small level, can get the ball rolling.
  3. Relying entirely on in-person care: In-person care is still the gold standard of care. However, by trying to rely on in-person care models alone, it can be challenging to get the right resources, at the right time, in a financially scalable way. Many organizations face insurmountable challenges recruiting onsite providers for some of their rural and urban settings. Virtual care transcends city, county, and state barriers, so patients have access to care regardless of location.
  4. Triage and care navigation challenges: These approaches can be a challenge and lead to too much responsibility for the primary care provider. Primary care providers need help from the right behavioral health specialists for their most complex patients, and they need it in a timely manner. Partnering with virtual care providers in the navigation process can take additional burdens off patients and PCPs.

How Our Virtual Clinic Solution Enables Behavioral Health Integration

For health systems looking to implement integrated behavioral health services, Virtual Clinic ensures the patients who need care first get care first – while being efficiently directed to an appropriate care plan.

Virtual Clinic leverages virtual care and an evidence-based care model to ensure patients that need escalation from primary care receive timely access to high-quality behavioral care, including therapy, medication management, or both.

This approach fills gaps in ambulatory and post-acute behavioral health care for patients, helping health systems achieve measurement-based outcomes and optimizing reimbursement for a financially sustainable behavioral health program. 

With Virtual Clinic, the pathway begins with a billable biopsychosocial needs assessment delivered by a licensed therapy provider within seven days of a patient’s discharge. The provider then determines the appropriate behavioral health specialist to manage the patient’s care needs with counseling, medication management, or both.

The care navigation and therapeutic support from this approach alleviate the burden on the health system’s resources using a cost-effective process that closes referrals to specialists sooner and returns patients to community providers when available.

Behavioral Health Integration at Iris Telehealth

The demand for virtual behavioral health services will continue to grow, fueled by patient needs, psychiatrist s and the emphasis on integrated care.

Providers who embrace these services will not only improve the timeliness of the behavioral health care they deliver, the health of their patients, and their own work satisfaction, but will also ensure their viability in a new world of consumer-centric healthcare.

If you’d like to learn more about Iris Telehealth and how can help your health care organization implement Behavioral Health Integration into your practice, feel free to reach out today.

How PMHNPs Can Give Your Organization a Strategic Benefit 

Psychiatric Mental Health Nurse Practitioners (PMHNPs) make for exceptional members and leaders of care teams. Generally speaking, PMHNPs not only have very diverse educational backgrounds, but they undergo a variety of trainings and are experts in delivering effective behavioral health care.  

I’ve seen the impact PMHNPs can make for healthcare organizations first-hand across my 20-year career as a PMHNP and from my experience serving as Iris Telehealth’s Lead Psychiatric Nurse Practitioner. Over those years, here are the best practices I’ve seen for how organizations can effectively leverage PMHNPs and some of the specific benefits their communities experience when they lean into PMHNPs.  

How organizations can leverage PMHNPs for their behavioral health programs 

At Iris, we work with organizations all across the country to support the various needs of their patients.  

Here are some of the primary ways our partners leverage PMHNPs for behavioral health services:  

  • Telepsychiatry: Organizations in rural communities or those experiencing the effects of the provider shortage have found great success in leveraging PMHNPs via telepsychiatry. While PMHNPs tend to live on the East Coast, telepsychiatry makes their services widely available.  
  • Crisis intervention: PMHNPs are excellent at deescalating volatile situations. Once a situation is handled and the patient is triaged to an inpatient psychiatric unit, we provide follow-up care and execute quality improvement initiatives. We are excellent at keeping up with data and showing where our helps and enhances the overall effectiveness of our outcomes.  
  • Patient advocacy: Another area where PMHNPs excel is communication. Many of our patients feel PMHNPs can speak at their level. We’re nurses first and understand the importance of bedside manner. We carry that into our treatment, and patients feel they can communicate effectively with us.  
  • Medication management: A lot of organizations utilize PMHNPs for medication management because they have therapists who conduct therapy. While we always end up doing a bit of therapy, the largest part of our job is talking to patients, seeing what their symptoms are, and determining if medication is appropriate for them. We then write a prescription and follow-up every one to three months according to how well they’re doing and adjust as needed.  

The role PMHNPs play in reducing mental health stigma  

In independent practice states, our skills can be leveraged for leadership roles or providing community outreach, whether that’s teaching people about mental health stigma or helping them learn about their conditions before they escalate into something more severe.   

For example, if a patient is worried about what people think about them getting treatment for their behavioral health condition, it might keep them from getting help. However, if an organization is leveraging a PMHNP for treatment, the PMHNP can explain how treating a behavioral health condition is just the same as treating diabetes or hypertension.  

Everyone wants someone to talk to and there’s nothing wrong with that. When you remove the stigma, people get in earlier, and they’re less likely to escalate to a higher severity and can stay more stabilized throughout their life span.  

The advantages of hiring a PMHNP 

Part of our job is reaching out and communicating with primary care doctors because we often share patients. It’s important for us to let them know the patients we treat, so if they have anyone who needs behavioral health support, they can send them our way. This communication enables the best care for the patient.  

That said, we are very integrated into the organization we serve, building relationships in the community and with the on-site team. This approach helps create the best experience possible for the patient and builds continuity of care.  

On the other hand, if an organization is working with a Locums, someone who is in and out, behavioral health patients don’t tend to respond well. People don’t like to tell their stories over and over and they don’t feel comfortable knowing that someone is only going to be there for a short time.  

However, they respond very well know that their PMHNP is “their person” and they can trust them because they’re a part of the team. By being integrated into the clinic, we become one of the employees there and we’re not going anywhere.  

Why bedside manner and communication is a PMHNP’s superpower  

People may not realize all the different aspects of what a PMHNP can provide. Nurse practitioners can do research, outreach, crisis intervention, and medication management. They can also work in both inpatient and outpatient settings and do step down roles. There are an endless number of jobs a nurse practitioner can do.  

I would say our superpower, though, is our bedside manner. We meet people where they are. Whenever you meet a patient, you have to figure out how they communicate. Some people walk in and they’re joking – they want someone to be lighthearted, so they’re comfortable. But they also want you to be serious and provide medication management. However, if you’re really serious and to the point, they’re not going to trust you.  

It’s important to learn about your patients and figure out what’s important to them. If someone mentions their family, it’s important to follow up with them the next time you see them. Ask how they’re doing. These are all important aspects of building a good relationship.  

Building your team of PMHNPs at Iris  

Over my 20 years as a PMHNP, I can say that at Iris, we have a wonderful set of nurse practitioners. We strive to have the highest quality providers around and we do a great job of finding the best of the best.  

If you’d like to learn more about PMHNPs and the benefits they can bring to your organization, feel free to contact us today and see how we can find the best provider fit for your community.   

You can also learn more about how PMHNPs can benefit your organization here.  

How Bridge Care Services Optimizes Behavioral Health Integration to Ensure Effective Patient Care  

Meeting behavioral health patients with timely support, appropriate care, and proper follow-up is essential to their care journeys. Unfortunately, finding the right care isn’t always easy. Between provider shortages, increased demand for behavioral health treatment, and social determinants of health, patients may spend a lot of time waiting for care without ever receiving the support they need.

Bridge Care Services ensures the patients who need care first get care first – while being efficiently directed to an appropriate care plan. Keep reading to learn more about how bridge care enables Behavioral Health Integration across health systems.

Table of contents
Bridge care 101
How Bridge Care Services works
The benefits of Bridge Care Services
Where Iris Telehealth fits in

Bridge care 101

A dedicated bridge care program can help support health systems via a behavioral health integration model backed by clinical and operational expertise to solve common challenges health systems face in delivering ambulatory care in a scalable and sustainable way. This model ensures patients with a behavioral health referral get timely, high-quality care and appropriate treatment and follow-up – all while improving a health system’s total cost of care.

Keys to success:

  1. Augmenting behavioral health access: Any system struggling with its referral volumes needs a mechanism to augment its clinical bandwidth to reduce its backlog – whether that means optimizing existing resources or leveraging a third-party partner like Iris Telehealth.
  2. Financial sustainability: Health systems have to maintain financial sustainability for any program to stand the test of time. A bridge care program should be designed accordingly and optimized for reimbursement.
  3. Care navigation: Clinical recommendations that direct the patient to the right type of care, from the right type of provider.
  4. Quality Management: To ensure the success of any program, your care team needs high visibility into what’s going right – and what’s going wrong – across your workflows and patient and clinical outcomes. Bridge care leverages clinical support and oversights throughout the care program lifecycle to manage data-driven outcomes and demonstrate clinical and operational impact.

How Bridge Care Services works

There are six components that make up Bridge Care Services and help more people get the care they need.

Here’s how those components work to support health systems:

  • Cross-functional care team: Our cross-functional care team of psychiatrists, therapists, and psychiatric mental health nurse practitioners will fully integrate into your health system.
  • Clinical prioritization: Referred patients are entered into a risk-stratified patient registry that undergoes a clinical review to ensure the patients who need help first, get seen first.
  • Navigation assessments: A Licensed Clinical Social Worker will complete a Navigation Assessment to determine the appropriate level of care.
  • High-quality care: Patients referred to Iris will receive the appropriate care plan for their needs. Whether that is medication management, therapy or both – and whether that is short-term care or longer-term care – we ensure each patient receives efficient, quality care.
  • Collaborative transition:Once a patient can be safely managed by their primary care provider, ambulatory service, or community clinic – an Iris Care Coordinator helps facilitate a supported transition to the next care setting in the patient’s journey.
  • Iris Insights:Your health system will have the backing of Iris clinical and operational excellence to ensure sustainable behavioral health care.

Click here for a more in-depth look at how Bridge Care Services works.

The benefits of Bridge Care Services

With the immense need for care, health systems are overwhelmed. Thankfully, Bridge Care Services can help organizations with the influx they’re experiencing, provide additional support, and continue providing the highest quality of care they’re accustomed to delivering to their patients.

When implemented properly in a health system, Bridge Care Services can help:

  • Improve total cost of care
  • Deliver optimized Behavioral Health Integration across the whole system
  • Support organizational quality measures
  • Increase patient satisfaction
  • Decrease provider burnout
  • Retain patients within the health system
  • Keep patients in the referral queue out of the ED
  • Support longitudinal care
  • Reduce 30-day readmission rates
  • Promote referring provider satisfaction

Bridge Care Services helps provide a transformative process for health systems, their teams, and the patients they serve.

Where Iris Telehealth fits in

At Iris Telehealth, we believe patients deserve access to high-quality behavioral health care. That’s why we walk with them throughout their care journeys to help ensure they get the most effective care possible. If you’d like to learn more about our Bridge Care Services program, contact us today.

How Virtual Care Can Enable a Better Approach to Inpatient Psychiatric Care  

For health systems seeking to provide high-quality inpatient psychiatric care, it’s essential to prioritize learning what patients need, how best to support them on their care journey, and how to connect with patients. While in-person care remains the gold standard, giving patients a virtual option can help reduce no-shows and ensure patients aren’t seeking behavioral health care in the ED.     

In a webinar hosted by Becker’s Hospital Review, healthcare leaders from Carilion Clinic and Basset Health Network came together to discuss how they’re leveraging partnerships with telehealth organizations to overcome hiring challenges and help their communities get the best care possible. 

They were also joined by two providers, Dr. Tisa Ayuso and Dr. Ghazanfar Khan, who shared their experience providing virtual behavioral health care in an inpatient setting. 

How Carilion Clinic overcame staffing challenges during COVID-19 and beyond 

Laura Taylor, the Program Director of Psychiatry at Carilion Clinic spoke to the organization’s challenges navigating call outs during the COVID-19 pandemic. At one point, the organization had to shut down the unit and then reopen. Taylor said, “It took a lot of time to navigate scheduling to make sure that we were staffed appropriately to meet the patient needs on the unit.”  

From the hiring perspective, it took months for physicians to complete their credentialing. However, after partnering with Iris, Carilion was able to attain a reliable provider.  

Reflecting on this time, Taylor said, “To have an established Iris Telehealth provider was incredibly important because it created reliability on the unit. We knew exactly what we were working with when we had the physician. She was very reliable, and it created continuity of care.”  

Basset Health Network’s approach to staffing providers in rural New York  

Basset Health Network is in upstate New York, where its patients are geographically dispersed across the region.  

Amid cross-departmental changes, Basset found itself with a shortage of clinicians on the inpatient side.  

While they were in the recruitment process, they couldn’t hire clinicians fast enough. They had leveraged locums to help run their inpatient unit, but they needed a long-term solution that would almost exclusively provide physician oversight on the inpatient unit. Dr. James Anderson, Chief of the Department of Psychiatry at Basset, said they wanted to expand their approach to virtual care. 

Anderson said, “We thought in the long term, it was going to create a situation where we could offer more flexibility when looking at full-time staff members. Even if they weren’t working full-time in a virtual capacity, they would have that tool as part of their tool belt. 

So, whether it was because of illness or convenience, it’s an important arrow in our quiver to be able to expand virtual health to include providing services on the inpatient end.” 

The provider experience facilitating virtual care  

While Dr. Tisa Ayuso has been with Basset for a short time, she says her role as Virtual Medical Director has been going well. 

“We have our systems in place in terms of our morning rounds. We have the computer system up and running. We recently just got a fish-eye lens camera, so I have better visibility of seeing everyone in the morning meetings, which has been fantastic.” 

Along with working with patients, Dr. Ayuso also works with Bassett’s medical students to demonstrate best practices for delivering effective inpatient psychiatric care. 

Before working with Iris, Dr. Ghazanfar Khan started to experience the stress of the provider shortage and knew he wanted to make a change for his mental health. Since beginning his virtual inpatient role, Dr. Kahn enjoys focusing more on patients than commuting. 

“I’ve been able to focus more on my patients. I have charts pulled out when I’m seeing patients so that I can see their labs and medications and the nursing and social work notes. It has been working great for me. The hospital staff made it more convenient for me to transition from in-person to virtual.” 

The benefits and challenges of virtual care  

Virtual behavioral health makes it easier for patients to attend appointments and helps improve satisfaction overall. At Carilion, Taylor says that having a blended model has enhanced patient care. 

Reflecting on her observations, she said, “I had an opportunity to round with our telehealth psychiatrist, and rarely would I hear patients request a different provider. This provider was very good at building rapport quickly; they exchanged a wealth of information back and forth. I think patients felt very comfortable with that provider in a telehealth setting.”   

Besides a few technical glitches and finding the right place to take the video calls, Taylor says telehealth has been “almost seamless.” 

At Basset, Anderson says they’ve heard almost zero patient complaints about virtual care. He said the challenges they faced were mainly on the front end. 

He said, “I wouldn’t say it was a challenge, so much as there were legitimate questions and concerns from staff on the unit about how we were going to operate on a daily basis. There were concerns about how we would get Dr. Ayuso in the room. It turns out that wasn’t as big of a deal as some anticipated.” 

Anderson also expanded on the benefits, noting, “I just got an email today from our clerkship director who is in charge of the medical student’s psychiatry rotation. He said the students are having a fantastic experience, and they love Dr. Ayuso. 

In some ways, there’s some suspicion that there’s even more contact with Dr. Ayuso than there might be if the psychiatrist was there on the unit. It’s been a surprise to some of the staff members on the unit about how non-disruptive it has been.” 

Advice on finding the right telehealth partner  

At Basset, Anderson said they considered several things when searching for a behavioral health partner. “First,” he said, was “the ability to become impaneled with our various insurers. We absolutely want people that are willing and able to accept Medicare and Medicaid.” 

Next, Anderson said Basset was looking for a partner who could serve as a collaborating physician for their nurse practitioners. After talking with multiple telehealth companies, Basset landed on Iris Telehealth because of their ability to meet their needs. 

Anderson said, “It was really strong communication and project management. To help us, we came in, and we sort of knew where we wanted to get to, but we didn’t know how to get there. Iris had this combination of knowledge and commitment to clear and confident communication. They had willingness to collaborate, but also had proven ideas that worked before – that was a big plus. 

They also had a clear commitment to quality services. When Iris is presenting a clinician to us, we know that clinician has already been well vetted by Iris. By the time we’re talking to the clinician, there’s a little bit of a halo effect because of the trust we’ve built. 

It’s not sign unseen. We build the partnership, and we see that things are working in other areas – it made it a pretty easy choice to go with Iris, and we’ve been happy so far.” 

The importance of collaboration and quality support  

For Carilion, Taylor said relationships and communication are incredibly important to finding the right behavioral health partner. 

“Working with well-informed individuals who know exactly what to do, have had that experience, and can offer solutions while listening to needs. That’s what I’ve enjoyed so much about my relationship with Shannon.” 

Shannon works as a Client Alignment Executive (CAE) at Carilion. Taylor says she’s enjoyed working with her CAE, who helps figure out what Carilion needs, how Iris can meet those needs, and the creativity of thinking outside the box. 

“The ease of transitioning a provider into the Carilion system is flawless,” said Taylor. “Every need is thought of. Every detail is considered when it comes to invoicing and general backend operations.  

Everything is very streamlined. It’s predictable, and there are no surprises. It’s been a wonderful experience. It’s meant to support Carilion and Carilion’s needs and not create barriers.” 

Figure out your next steps  

We’re so grateful for the time Laura Taylor, Dr. James Anderson, Dr. Ayuso, and Dr. Ghazanfar Khan generously shared with us. Thank you for your partnership and for all you do to help expand access to quality behavioral health care in your communities!  

Weren’t able to make it to the webinar? You can watch the full video here.  

If you’d like to learn more about integrating quality behavioral health programs into your organization, contact us today to get started! 

Leverage Telepsychiatry to Build an Effective MAT Program

Access to high-quality substance-use disorder treatment has never been more important. The opioid epidemic continues to grow and impact more and more lives, families, and communities across the country. And, healthcare organizations must include some form of medication-assisted treatment (MAT) services for patients with substance use disorders and those seeking addiction treatment.

However, building an effective MAT program at your organization doesn’t have to involve a massive overhaul of your organization’s services. Working with a dedicated telepsychiatry or behavioral health partner can help if you’re just getting started and enable you to better expand your program to meet the growing needs of your community.

Note: This piece will focus on building a standard Office-Based Opioid Treatment program (OBOT) rather than a more intensive Opioid Treatment Program (OTP). If you’re hoping to learn more about providing OTP services, including methadone clinics, check out our full whitepaper on building an MAT program.

We will also share some insights from Iris Telehealth’s Chief Medical Officer, Dr. Thomas Milam throughout this piece for further insights into substance-use disorder and treatment.

Building an MAT program from scratch

Generally speaking, you’ll want to build out an OBOT program if you’re planning on prescribing Suboxone to treat patients with opioid-use disorders (OUDs). An OBOT program will allow prescribers with an X waiver to prescribe schedule III, IV, and V controlled substances to help treat those patients.

If that kind of treatment would be a good fit for your patients, make sure to keep in mind these key considerations when building your program:

  • Any providers participating in your OBOT program (i.e., prescribing these controlled substances, including Suboxone/buprenorphine) will need an X waiver. If your current providers don’t have their X waiver, they can undergo training from the DEA and apply for their waiver.
  • While your provider is receiving the appropriate training for their X waiver, your organization can start building what your OBOT program would look like. Alternatively, you can hire a provider who has their X waiver and specialized experience working with patients experiencing OUD who can help support your program. Remember, working with a strategic behavioral health partner can expand your access to highly qualified providers for your program.
  • To have a Suboxone program, you need to be able to refer patients to a counselor. If you don’t have internal counseling services available, you should have a formalized referral relationship with another provider or organization in your community that does.
  • Plan on having clinic staff available on-site to monitor patients when they start their first day of Suboxone.
  • When starting patients on Suboxone, you may initially have them come in once a week. Then you will likely see them once every three months for maintenance.
  • Your OBOT program will have record-keeping requirements that your organization must meet. You’ll need to comply with 42 CFR, a federal regulation requiring an additional standard of privacy than typical HIPAA requirements. You will need to keep a log of all patients currently (or previously) prescribed Suboxone. Generally, you can keep these records in your standard EMR.

Challenges and opportunities you might face

The number one challenge your healthcare organization will likely face is dealing with stigma. People with substance use disorders are often the victims of stigma, stereotypes, negative portrayals in the media, and preconceived notions around what those disorders look like.

However, there are steps you can take to overcome that challenge, and it all starts with education:

  1. Educate your staff: Provide comprehensive education to your team. Include an overview of medications (including medications like naltrexone, which doesn’t require any special licensing or certifications for prescribers). An MAT program doesn’t have to mean a methadone clinic. MAT services can be easily and seamlessly incorporated into the work your team is already doing.
  2. Educate your community: It will be essential to educate your community on what substance use disorders are (and what they aren’t) and that they do not discriminate based on social status, economic status, race, or background.
  3. Educate your patients: Spread the word. Let your patients know about the value of your MAT services, regardless of whether they have a documented SUD. Current patients may serve as an excellent referral source for community members in need of treatment.

Remember, the most significant benefit of building an MAT program is providing a valuable service to your community that will save lives.

Finding the right provider for your program

As you build out your program, it’s important to ensure you hire the right provider for your patient population, the kind of substance use disorders you treat, and your organization’s culture.

Here are some best practices for finding the right provider for your MAT program:

  • Make sure your provider has dedicated experience treating substance use disorders and is familiar with a wide range of treatment options.
  • If your organization serves patients experiencing opioid use disorders and plans on prescribing Suboxone, you should only consider providers with their X waiver or willing to get their X waiver.
  • Look for providers who have worked with patients like yours and understand the particular challenges they face.
  • If your organization is in a rural or underserved community, consider utilizing a strategic behavioral health partner to open up your provider pool.

Leverage partners to support telehealth MAT program offerings

Fortunately, you don’t have to build out your MAT program by yourself. Behavioral health partners like Iris Telehealth can be valuable resources to help your healthcare organization source and vet potential behavioral health providers for your program.

Here are some benefits to using a partner to develop an effective MAT telehealth program:

  • Leveraging partnerships that utilize telepsychiatry or virtual care will allow you to access high-quality providers from across the country who have their X waiver and can prescribe Suboxone.
  • Through a dedicated partner relationship, your organization can draw on the expertise and experience of organizations and providers who have been through this exact process and have seen effective MAT programs in action.
  • A behavioral health partner will be able to support the long-term, sustainable growth of your telehealth MAT program. This support will decrease the burden of recruitment and program implementation on your team.

If you’ve encountered challenges finding highly qualified providers in your area, we strongly recommend considering telehealth as an option to help you better serve your community.

Some key resources to get started

Countless clinics and healthcare organizations have successfully navigated this process, and you will be able to benefit from their guidance and experience. You can also on some helpful resources in the early stages of building your program.

Some resources to start with include:

Then, if you’re planning on utilizing strategic partnerships or telepsychiatry to build up your program or source highly qualified providers, Iris Telehealth can help your organization through that process. If you want to learn more about getting started, contact us today or download our comprehensive whitepaper on building an effective MAT program for more information.

How Health Systems Can Develop a Financially Sustainable Behavioral Health Program

In the U.S., 14.1 million people have a serious mental illness, making behavioral health treatment critical. However, significant barriers keep people from the care they need, including the provider shortage and lack of specialty care, leading people to seek treatment in the ED.

Building a financially sustainable behavioral health program at scale can help these patients get quality care and reduce the total spend on their medical conditions (for both the patients and the health systems providing treatment). Partnering with an organization that can facilitate efficient care models can help your organization scale services and meet quality measures that enable your health system to thrive.

In this blog, we’ll share the keys to building a financially sustainable behavioral health program and insights from our Chief Marketing & Strategy Officer, Dan Ferris, on the benefits and impact on total cost of care.

The benefits of achieving a financially sustainable behavioral health program

Every health system faces a hierarchy of needs regarding patient care – from those who need immediate care in the ED to those stuck in referral queues to those who need proactive outreach in the community.

Let’s take a look at the six ways achieving financial sustainability can benefit your patients and overall organization:

  • Increased revenue: In outpatient settings, many health systems are foregoing revenue by not having timely access available – driving unnecessarily high leakage and no-show rates. By having scalable care models that provide high-quality care, you can see and retain more patients.
  • Sustainable margins: To drive sustainable margins in outpatient behavioral healthcare, health systems must leverage a multidisciplinary care team that works top-of-license and deliberately ensures patients are navigated to the right resource at the right time in the right way.
  • Increased ED throughput: By augmenting your on-site care with a multidisciplinary team of behavioral health providers available 24/7/365, you can ensure every patient receives timely access to quality care and is not taking up valuable space in the ED longer than is clinically appropriate.
  • Reduced admissions: By having access to a variety of virtual providers, like licensed counselors, PMHNPs, and MDs, on your team, patients are more likely to get to the right level of care and help ensure only the most critical are admitted, and those who might be more effectively treated in a lower level of care get the help they need. Ultimately, this approach can help decrease long-term costs.
  • Limited revisit rates: By providing the most effective care possible, and ensuring every patient has an optimal discharge plan to manage their mental health, patients are less likely to come back to your hospital. At the same time, it can also better position your organization to retain patients within your network.
  • Improved total cost of care: By treating behavioral health, you get the benefits of integrated behavioral health care. That’s because alongside physical conditions, you’re helping total cost of care over time, and increasing key metrics like pharmacy cost, reducing length of stay, and improving patient outcomes.

All six of these benefits combined help create a behavioral health program that’s both efficient and successful. Next, we’ll review the quality care models that help make financial sustainability in behavioral health care possible.

Care models that build a financially sustainable future

At Iris, we design programs that seamlessly integrate into a health system and connect organizations with the highest quality behavioral health specialists. These services have helped organizations reduce their referral backlog by 83%, divert 36% of psych referrals to a lower level of care, and improve depression symptoms by 38% over eight weeks of care. You can read the full story here.

Here’s a look inside how our services work

Bridge Care Services: A Behavioral Health Integration model backed by clinical and operational expertise to solve ambulatory care at scale and deliver long-term clinical and financial outcomes for hospitals and health systems. We ensure the patients who need care first get care first – while being efficiently directed to an appropriate care plan. Our cross-functional care team of psychiatrists, therapists, and psychiatric mental health nurse practitioners will fully integrate into your health system. When clinically appropriate, our team will facilitate collaborative transitions to additional ambulatory services, primary care, and community partners as needed.

Key takeaway: Bridge Care Services hits target metrics such as expanding and accelerating access to care and achieving critical financial results like increasing revenue, driving sustainable margins, and improving total cost of care.

On-Demand Services: These services leverage a team of providers to help support ED and MedSurg units with on-demand consults 24/7 – ensuring your health system is never without a behavioral health specialist. On-Demand Services provides access to providers who are experts in assessing and managing risk to help patients get triaged and evaluated as quickly as possible.

Key takeaway: On-Demand Services leads to increased ED throughput, decreased inpatient admissions, and reduced revisit rates.

Scheduled Services: This approach provides a predictable coverage model for organizations, meaning your virtual providers are available on a regular schedule each week. Most importantly, it means your providers are never without a behavioral health provider to lean on for their expertise.

Key takeaway: Scheduled Services expands patient access to behavioral health care, increases revenue, and improves total cost of care.

Laying the foundation for whole-person care

Physical and behavioral health are intrinsically linked. For example, research from the National Library of Medicine shows that 74.9% of psychiatric inpatients had at least one medical comorbidity, including 57.5% of people ages 18-24.

If you’re managing total cost of care and population health, behavioral health integration is essential.

According to a behavioral health analysis by Evernorth Health Services, treating behavioral health conditions in outpatient care is directly tied with a reduction in medical and pharmacy costs. In their analysis, they highlight savings up to $2,565 per person over the 15 months following a diagnosis and up to $3,321 per person over the 27 months following a diagnosis.

Where Iris Telehealth fits in

Iris Telehealth delivers high-quality behavioral health services via telehealth all across the country. From our rigorous provider vetting process to our in-depth knowledge and expertise, we help ensure your organization has a thriving, financially stable behavioral health program.

Contact us today to learn more about our care models and how we can help your organization increase ED throughput and provide short-term care to your patient population.

Telepsychiatry in Action: Meet our Clinical Hiring Team

At Iris, we’re proud to offer a top-notch experience for our clinicians and partners by helping ensure excellent, long-term provider matches. This process, called The Iris Match, helps clinicians find an organization that aligns with their values and needs and enables our partners to secure a provider their patients and providers will love. 

Leading this effort is our incredible clinical hiring team. In this blog, we’re excited to share more about this team’s mission, their approach to hiring behavioral health providers, and how they go above and beyond to help ensure our providers are set up for success. 

The mission of the clinical hiring team 

The clinical hiring team comprises Clinical Hiring Managers (CHMs), Clinical Talent Consultants (CTCs), and Clinical Recruitment Coordinators (CRCs). This team revolves around collaboration, starting with the CRCs, who process provider applications through interviews with the CTCs and placements with the CHMs. 

On the organizational side, this team talks with partner groups to learn about their culture, patient population, and all the soft and hard skills providers will need to succeed. From start to finish, everyone is laser-focused on longitudinal matches with quality providers.

Life in clinical hiring is different each day. Whether they’re talking with providers and potential partners or attending meet and greets between the two, they’re invigorated by finding the best matches for each party. 

When zooming out, what sets this team apart is the dedication to their mission. The clinical hiring team is keenly aware of what patients must endure when there are gaps in coverage. That’s why they ensure they’re not just filling a role but making a mindful, high-quality, long-term match. This mission helps organizations with provider retention amid a shortage of behavioral health providers. 

So, what does our clinical hiring team look for when finding that perfect match? Let’s take a closer look.

What makes an excellent Iris provider

At Iris, we pride ourselves on working with the best of the best providers. While so many healthcare organizations need excellent providers, there are a few key components that we’ve found in making quality, long-term matches. 

In community mental health, an excellent provider understands the patient population, the complexities of delivering care to that population, and the demand it can have on them. We’re proud to give voice to the voiceless, and it requires a provider with compassion, understanding, and someone free from judgment.

Additionally, continuity of care is a significant focus for our organization, and we look for that shared value in our providers, too. Resilience is another tool we look for in our providers. By having something in place to help them avoid compassion fatigue and the secondary trauma that comes with these roles is essential.

For our providers, we help ensure they have the operational support they need in their daily work. For example, our Clinical Operation Managers (COMs) help ensure our providers have things like administrative and operational hurdles taken care of so they can focus on patient care. 

To learn more about our Clinical Operation Managers, check out their spotlight here. 

Providers also benefit from our mindful matches. At Iris, we don’t take a plug-and-play approach. Instead, we consider many components of the job to help ensure it matches what our providers want. For instance, we look at the community where they’ll be placed, ask if they’re comfortable seeing a particular patient population, and make sure their skill set is a match for the organization. 

The matchmaking process 

To help assist with making the best long-term match possible, there are a few considerations our clinical hiring team must learn about the providers. For example, do they have a specific prescribing or therapeutic approach they adhere to? Is there a specific population they want to work with? This team also assesses things like personality and communication style to ensure they’d be a good fit for our partners. 

From our partners, we might ask them any of the following questions:

  • What are you looking for in a clinician? 
  • Do you need someone who is more independent or who wants to be a part of the team? 
  • Do you need someone with specific soft skills? 
  • What kind of support do you have on the ground? 

As part of our rigorous vetting process, the clinical hiring team also does multiple interviews with the providers. This thorough process helps ensure that we’re not just filling slots, but making intentional matches. 

When working to make a match, the clinical hiring team asks themselves, “Would I trust someone I love with this provider?” And if the answer is no, then they may not be the best fit. 

Learn more about the support Team Iris provides

If you’d like to learn how our clinical hiring team can help your organization find the best provider fit for your population, contact us today! 

Additionally, if you’d like to learn more about the other pillars of support our teams provide, check out our other spotlights here:

At Iris, we’re proud to provide quality support to all our partners so they can help their patient population get the quality behavioral health care they need. 

How Virtual Care Boosts Patient Satisfaction

Lack of access to proper psychiatric care in the United States is a major challenge for our healthcare system. However, virtual solutions make psychiatric care more accessible, effective, and patient-centered.

The benefits of virtual care for patients are significant. In fact, a study by the American Medical Association demonstrated 79% patient satisfaction with telehealth. For patients, virtual care opens up access to behavioral health services, facilitates shorter wait times, and cuts out the commute to the doctor’s office.

While these benefits are essential, let’s take a closer look at all the ways virtual care boosts patient satisfaction. 

State of virtual behavioral health care

During the COVID-19 pandemic, many people found themselves relying on telehealth to get care. In fact, during the first four months of COVID-19, telehealth visits accounted for 23.6% of all interactions. Today, telehealth continues to provide care to those who cannot reach behavioral health services as easily.

Following the COVID-19 pandemic, many hospitals and health systems continue to experience challenges meeting patient volume and needs with limited behavioral health resources.

Additionally, the ongoing provider shortage underscores the importance of leveraging virtual care as patients still struggle to receive timely care. Thankfully, telepsychiatry can ensure patients receive quality, timely, and sustainable care by connecting them to providers regardless of geographic location.

Patient satisfaction by the numbers

Convenience is an essential factor that contributes to patient satisfaction. According to the American Medical Association, 62% of physicians feel like their patients have higher satisfaction since they’ve started offering virtual care as an option.

At Iris, our clinicians have a similar experience with patient satisfaction. Dr. Kavita Vasu, one of our psychiatrists, says virtual care gives her patients flexibility, allowing them to access care from wherever they are – whether at home or work. Dr. Vasu also notes that no-show rates are significantly lower.

Additionally, research shows that virtual care is an effective way to increase patient access. According to the 2022 CVS Health Care insights, 59% of patients said that accessing virtual telehealth services was essential to their health.

Overall, the data is clear – patient satisfaction with virtual care is high. 

The J.D. Power 2022 U.S. Telehealth Satisfaction Study says that a growing number of patients prefer telehealth visits for various types of care, including routine care, prescription refills, and regular mental health visits. The survey also says 94% of patients and their families who have used telehealth in the past “definitely will” or “probably will” continue to utilize it.

Virtual care reaches those who need care most

In a database released by the Health Resources & Services Administration, numbers show that 157 million people live in a mental health professional shortage area (HPSA). Virtual care makes access to specialty behavioral health providers more easily available to those who live far from care.

Here are just a few of the populations that benefit from telepsychiatry access:

  • LGBTQIA+: For LGBTQIA+ youth, access to mental health can be difficult due to inadequate mental health care, fear of discussing mental health concerns, and stigma. Utilizing virtual care can help LGBTQIA+ youth overcome some of these barriers by promoting a safe and accessible method for the delivery of care.
  • Youth: Child psychiatry is more important than ever, with the American Academy of Pediatrics, the American Hospital Association, and the American Academy of Child Adolescent Psychiatry declaring a mental health emergency for youth in October 2021. With virtual care, children can be screened for mental health conditions, and have a psychiatrist ready to support and treat them. Additionally, parents no longer have to take time out of their day to bring their children to their mental health appointments, making care more convenient for both families and children.
  • Geriatric populations: Early intervention, collaborative care, and a holistic approach are both vital when it comes to addressing the health of the geriatric population in your community. Virtual care can be an essential tool for older adults to receive care from the comfort of their own homes while maintaining a sense of autonomy.
  • Rural populations: Barriers like limited health literacy, transportation challenges, and privacy are just a few challenges that rural populations face when they’re trying to get the care they need. However, virtual care provides an opportunity for rural communities to connect to a high-quality mental health provider without a long commute and fear of stigma.
  • Underserved populations: Social determinants of health create and exacerbate mental illness by making access to mental health care more difficult. Access to providers that are culturally competent can allow minorities to connect with a provider who can better relate to their experiences.

How virtual care boosts patient satisfaction in the ED

In the emergency department (ED), virtual care can allow patients faster access to behavioral health care through a virtual visit. This improved access means patients don’t have to wait hours to receive treatment and can have a shorter stay in the ED – leading to an improved patient experience overall. 

Avoiding ED boarding is crucial to patient satisfaction, as there are many downstream harms that can come with it. The Joint Commission (TJC) recently shared how boarding is a patient safety risk that leads to increased medical errors, compromised patient privacy, and increased mortality, especially if it exceeds four hours. With the help of virtual care, organizations can  increase throughput in the ED and decrease the need for patient boarding.

How Iris can help

At Iris Telehealth, we envision a better world through healthy minds. If you’re looking to meet the behavioral needs of your community and help your patients achieve better health outcomes, telepsychiatry is the perfect solution. Contact us today if you’d like to learn more about implementing telepsychiatry into your organization. 

Five Things You Should Know Before Building a Telehealth Program In-House

Over the last several years, it’s become clear that telehealth is here to stay. According to the American Psychiatric Association, nearly 60% of Americans would use telehealth for mental healthcare, and 43% currently want to continue using telehealth services when the pandemic is over.

With that data — and telehealth’s ability to expand access to high-quality providers — it’s no surprise that organizations are thinking through how to start a telemental health practice and leverage it as a long-term solution.

But, if your organization is wondering how to build a telepsychiatry practice in-house, you should consider some important first steps, limitations, and potential alternatives (like formal behavioral health vendor partnerships).

1. Building a telehealth program in-house won’t solve any recruitment challenges

As a medical group dedicated to providing virtual care services to healthcare organizations across the country, Iris Telehealth has access to a provider pool that spans all 50 states. However, individual organizations just starting to transition to telehealth as a long-term solution will likely be limited to the same provider pool they’d use for in-person providers.

And that’s not the only challenge you might encounter. For example, if you have an in-person provider who you think might transition to telehealth on a full-time or part-time basis, they may decide they don’t like telepsychiatry after all. Or they may get scooped up by another organization because they’re not limited by geographical location anymore.

At Iris, however, we not only assess their clinical skills, but their technical skills and screen presence as well. We have an intensive vetting process to make sure telepsychiatry is a good fit for that individual provider.

2. A formal telehealth program requires specific technological considerations

As you’re learning how to start a telepsychiatry practice in-house, you should ask yourself these questions:

  • Do we have the right video platform?
  • Do we have the right security in place (i.e. VPNs)?
  • Will our platform work for our current staff and patients?
  • Is our program HIPAA compliant?
  • Do we have sufficient IT support for handling technological difficulties or glitches?

If you’re uncertain about the answers to any of these questions, a vendor partner like Iris Telehealth might benefit you and your team as you navigate this process. (And, even if we’re not an official partner of yours, we’d be happy to talk through your needs with you.)

3. The telehealth landscape is constantly changing (and may be hard to navigate on your own)

Policies in the behavioral health space continue to evolve. Whether it’s around HIPAA compliance, reimbursements for audio-only appointments, or billing and coding — things continue to change as more states pass legislation that permanently expands telehealth services.

It can be challenging to stay on top of all the relevant changes as just one healthcare organization. No matter your size or approach to telehealth, the organization needed to manage telehealth-specific policies will likely be a big lift for your team.

That’s where a vendor partner may come in handy to offer perspectives on how similar organizations are navigating this space right now.

4. You’ll need dedicated, telehealth-specific policies for your providers

There’s a lot of information and “what ifs” to consider if you’re trying to build your own telehealth program.

Here are just a few of the policies you might want to put into place:

  • A standard 90-day grace period for providers leaving your organization. If you don’t tell your provider when they start that they have to give you 90 days’ notice, you may not have time to find a replacement provider when they leave. 90-day policies protect clinics, providers, and patients.
  • A strong policy around computer usage. You don’t want someone accidentally putting a virus on your network if they’re using their computer for other things or are engaging with spammy content.
  • No-show policies and policies for telehealth, specifically around remote patients (not in your clinic).
  • Policies around when the telehealth provider should end a session or not have a session with a particular patient.
  • A billing policy for patients who show up late to appointments.
  • Standard prescribing rules and protocols.

5. Your EMR may not be set up for behavioral health or telehealth right now

If you’re determined to build your telehealth program in-house, the first thing you need to look at is the capabilities and limitations of your EMR.

Make sure you have it set up for behavioral health before you do anything else. A common mistake organizations (particularly FQHCs and CHCs beginning psych services for the first time) make is trying to run their virtual behavioral health program the same way they run their primary care. When that happens, they often end up overbooking providers. But behavioral health is a different paradigm.

Remember, ideally, you want your EMR to be able to encompass your scheduling, patient records, e-prescribing, and video in one system.

A formal behavioral health partner could help support you and your organization

One of the unique benefits of telepsychiatry and a partnership with Iris is our Clinical Operations Managers (COMs). We’re a concierge service whose number one goal is making sure you and your patients are getting the care and support you need. If, for example, there’s a scheduling issue or a provider conflict we can help resolve it using solutions we have seen and used at clinics across the country.

Every day, we help mediate and advocate for clinics and clinicians to ensure there’s efficient and effective patient care.

Here’s what that would mean for your organization:

  • Our 24/7 IT support can interface with your organization’s IT to solve problems and can often independently solve them for our providers.
  • We have support for billing and scheduling issues.
  • We are Joint Commission accredited — which means we can assist with provider credentialing and paneling (we have some partners who do credentialing by proxy with us).
  • We match your organization with a top-quality provider who specializes in the areas you need (and who we’ve already vetted to ensure virtual care is a good fit for them).
  • After we’ve matched a provider with your organization, we help make sure they have the right technology and that the doctor knows what they need to know to evaluate your patients.
  • We assume all of the expenses of the benefits and PTO.
  • We are a true partner dedicated to long-term care and service. We make sure our providers are an extension of your team and do everything in our power to ensure continuity of care for your patients.

Whether you’re interested in learning how to make your own program a success or creating a formal partnership with Iris, we’re here to help. Contact us today to get the conversation started.

How Virtual Care Can Transform Your Health System’s Approach to Behavioral Health

Integrating behavioral health across all patient journeys can transform a health system and how it delivers care for its community.

As Chief Strategy & Marketing Officer at Iris Telehealth, I’ve seen first-hand the impact effective behavioral health integration can have on a health system and its patients. Whether through better clinical outcomes and access, increased revenue, or positive margins – our health system partners sustainably leverage and integrate scalable behavioral health services seamlessly across their ecosystem.

Learn how our partners are finding success by integrating behavioral health services across their health systems, what the patient journey looks like through a virtual lens, and the financial impact virtual services can have on a health system.

The tangible impact of integrating behavioral health services

Experiencing the tangible impacts of integrated behavioral health services starts by providing timely access to quality care – and making sure that care is financially sustainable.

Once the need for behavioral health care is met, health systems may experience the following benefits:

  • Better access
  • Better patient outcomes
  • Improved financials
  • Reduced total cost of care
  • A patient and provider community that feels supported

Helping health systems take back control of a fragmented healthcare landscape

Today, health systems are being disaggregated by a myriad of competitors – both new and old. This trend is contributing to lower health system revenue, but also to a further fragmentation of the patient journey. At Iris, we want to help health systems take back control of this fragmentation to ensure patients are getting integrated, whole-person care.

We believe providing integrated behavioral healthcare is a critical component to patient care. The reality is – behavioral healthcare should be infused into every journey. Whether a patient just received a cancer diagnosis, is an expecting mother, or is experiencing escalating anxiety at a primary care appointment, integrating behavioral health care will drive better patient care and eliminate the need for a patient to look elsewhere to fill gaps in their care needs.

At the end of the day, our goal is to help health systems deliver on their ultimate promise of delivering whole-person, integrated care.

How to integrate virtual services across a health system

The mistake many health systems make is believing that integrating virtual care into their health system is as simple as having virtual providers available to see patients. In practice, it is much more nuanced. We believe in the concept of “integrating virtual care locally” – whereby the referring provider knows and trusts the behavioral health care team they are relying on, and the virtual team truly knows the local dynamics. This approach is really the only way to build trust and create true continuity of care.

Additionally, the care experience has to be the same whether a patient is part of an Iris program or not. That is why our entire patient journey is built with the idea of integrating into, and leveraging, the health system technology already in place. The Iris provider is integrated seamlessly into the health system and the patient journey feels no different than it would if they were seeing an in-person provider.

The financial impact of integrating behavioral health services

The financial realities of providing behavioral healthcare are undoubtedly a challenge. But, in our experience, it is possible to deliver high-quality behavioral health care and have it be financially sustainable.

We have helped health systems double their behavioral health revenue while delivering a 10% program operating margin. And, study after study shows that providing outpatient behavioral healthcare reduces the total cost of care.

How is this impact possible? It comes down to the disciplined execution of a few key tenets:

  • First, ensure you’re driving top-of-license care from a true care team approach. Yes, it is essential to have psychiatrists available for high acuity patients, but from our experience, we’ve seen psychiatrists relied on too heavily for patient care than what is clinically appropriate. That is why we leverage industry-leading navigation assessments, with a true care team approach to make sure every patient is seen by their optimal provider with a tailored care plan.
  • Second, be sure to optimize the operational complexities of care delivery. Patient no-show rates, provider turnover, full provider panels, and consultation with referring providers are all critical to ensuring the program is sustainable.
  • Finally, revenue cycle optimization is critical. Many health systems are not getting paid optimally for the care they provide and that has to change. Revenue cycle optimization means ensuring the optimal codes are being billed, providers are documenting appropriately, and payers are approving claims. Constant measurement, continuous improvement and dialogue with payers are critical, and can make a significant difference.

It is a reality that if there is “no money, there is no mission,” and therefore we are dedicated to ensuring our programs deliver on high clinical quality and financial sustainability.

The spirit of partnership with Iris Telehealth

At Iris, one of our core values is to suck less every day, which speaks to our commitment to continuous improvement and our journey to excellence. No health system has behavioral health figured out, and no health system expects to be perfect tomorrow. Everyone’s on a journey to be better than they were yesterday. If together we commit to continual improvement, we will make a lot of progress and deliver better care for our communities.

If you’d like to learn more about how we can work together, don’t hesitate to contact us today!

As Chief Strategy & Marketing Officer, Dan Ferris drives strategy and revenue growth acceleration by identifying market opportunities and increasing awareness of how Iris can uniquely solve customer needs. Dan brings twenty years of healthcare experience in various marketing, product and strategy roles at Hillrom, CIGNA, Abbott, and Putnam Associates, a healthcare strategy consultancy.