Strategies for Integrating and Coordinating Care for Behavioral Health Populations: Case Studies of Four States. A. Program Overview

01/01/2014

Vermont Blueprint for Health (Blueprint) is a public-private patient-centered medical home (PCMH) program for improving health, wellness, and disease prevention. It aims to transform service delivery at the local level by helping local health and social service providers coordinate resources. Blueprint encompasses a variety of initiatives and has continued to expand in scope since it was first implemented in 2006. The two major reforms to date have been: (1) to incentivize and equip all willing PCPs to transition to NCQA-certified PCMHs; and (2) to implement locally developed multidisciplinary community health teams (CHTs), which expand the capacity of PCMHs, coordinate care and social service linkages for patients, and provide more intensive services to those with the most complex needs. Blueprint also supports patient self-management workshops, multiple services for providers to transition to PCMHs, and a health information technology (HIT) infrastructure that facilitates targeted outreach, population management, continuous quality-improvement, and evaluation. Other Blueprint services target specific populations. Multi-insurer payment reforms have accompanied these practice reforms. Medicaid, Medicare, and the state's largest commercial insurers make quality incentive payments to PCMHs based on their NCQA score, and they also contribute to funds for core members of CHTs.

Although Blueprint is not specifically focused on behavioral health, CHTs typically support patients with complex needs, including patients with SMI. In addition, Blueprint seeks to increase the capacity of PCPs to care for mental health and substance abuse conditions within their practices by equipping them to screen for, provide basic treatment for, and monitor common mental health conditions. Blueprint also seeks to strengthen collaborations with behavioral health providers. Finally, it has expanded implementation of Wellness Recovery Action Planning (WRAP) workshops and is in the process of extending the health home concept to providers of mental health and addiction treatment services.

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