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推进初级保健行为健康(PCBH)模式的立法与政策发展及必要性

Legislative and Policy Developments and Imperatives for Advancing the Primary Care Behavioral Health (PCBH) Model.

作者信息

Freeman Dennis S, Hudgins Cathy, Hornberger Joel

机构信息

Cherokee Health Systems, 2018 Western Avenue, Knoxville, TN, 37921, USA.

Southwest Virginia Area Health Education Center, Blacksburg, VA, USA.

出版信息

J Clin Psychol Med Settings. 2018 Jun;25(2):210-223. doi: 10.1007/s10880-018-9557-8.

Abstract

The Primary Care Behavioral Health (PCBH) practice model continues to gain converts among primary care and behavioral health professionals as the evidence supporting its effectiveness continues to accumulate. Despite a growing number of practices and organizations using the model effectively, widespread implementation has been hampered by outmoded policies and regulatory barriers. As policymakers and legislators begin to recognize the contributions that PCBH model services make to the care of complex patients and the expansion of access to those in need of behavioral health interventions, some encouraging policy initiatives are emerging and the policy environment is becoming more favorable to implementation of the PCBH model. This article outlines the necessity for policy change, exposing the policy issues and barriers that serve to limit the practice of the PCBH model; highlights innovative approaches some states are taking to foster integrated practice; and discusses the compatibility of the PCBH model with the nation's health care reform agenda. Psychologists have emerged as leaders in the design and implementation of PCBH model integration and are encouraged to continue to advance the model through the demonstration of efficient and effective clinical practice, participation in the expansion of an appropriately trained workforce, and advocacy for the inclusion of this practice model in emerging healthcare systems and value-based payment methodologies.

摘要

随着支持初级保健行为健康(PCBH)实践模式有效性的证据不断积累,该模式在初级保健和行为健康专业人员中持续吸引着越来越多的追随者。尽管越来越多的医疗机构和组织有效地采用了该模式,但过时的政策和监管障碍阻碍了其广泛实施。随着政策制定者和立法者开始认识到PCBH模式服务对复杂患者护理以及为有行为健康干预需求者扩大服务可及性所做的贡献,一些令人鼓舞的政策举措正在出现,政策环境也变得更有利于PCBH模式的实施。本文概述了政策变革的必要性,揭示了限制PCBH模式实践的政策问题和障碍;强调了一些州为促进综合实践所采取的创新方法;并讨论了PCBH模式与国家医疗改革议程的兼容性。心理学家已成为PCBH模式整合设计和实施的领导者,并受到鼓励通过展示高效且有效的临床实践、参与扩大经过适当培训的劳动力队伍以及倡导将这种实践模式纳入新兴医疗系统和基于价值的支付方法等方式,继续推动该模式发展。

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