Can Including Psychologists in Primary Care Reduce Cost of Care?

While patients may shy away from visiting psychologists for a number of reasons, including psychologists as part of the core primary care team appears to have had an effect on patient willingness to accept care for mental health, according to the report.

The structure of the primary care visit, should the primary care physician believe counseling is a necessary part of a patient’s treatment, is also different. It includes a 20-minute visit from the psychologist in the primary care physician’s office, which is a significant departure from the traditional scheduling of two separate visits, one for primary care and one for mental health.

Psychologists may be called in to see a variety of patients, including head injury patients, patients going through difficult periods of life and patients who may be mentally ill.  These designations also apply with pediatric patients.

The visit structure poses some challenges — it appears to have worked for only some clinicians, who may feel the structure and time-limit of the visit makes it difficult for them to provide care in the manner to which they are accustomed.

Bend, Ore.-based St. Charles Health System has been piloting this system for two years, during which psychologists have seen 400 Medicare patients under the model. The system reports costs of care have dropped by nearly $1,000, from $7,650 to $6,800 annually, according to the report.

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