Article

Psychiatrists for medically complex patients: bringing value at the physical health and mental health/substance-use disorder interface.

Dept. of Internal Medicine and Psychiatry, Univ. of Minnesota, USA.
Psychosomatics (Impact Factor: 1.67). 03/2009; 50(2):93-107. DOI: 10.1176/appi.psy.50.2.93
Source: PubMed

ABSTRACT In their current configuration, traditional reactive consultation-liaison services see a small percentage of the general-hospital patients who could benefit from their care. These services are poorly reimbursed and bring limited value in terms of clinical improvement and reduction in health-service use.
The authors examine models of cross-disciplinary, integrated health services that have been shown to promote health and lower cost in medically-complex patients, those with complicated admixtures of physical, mental, social, and health-system difficulties.
Psychiatrists who specialize in the treatment of medically-complex patients must now consider a transition from traditional consultation to proactive, value-added programs and bill for services from medical, rather than behavioral, insurance dollars, since the majority of health-enhancement and cost-savings from these programs occur in the medical sector. The authors provide the clinical and financial arguments for such program-creation and the steps that can be taken as psychiatrists for medically-complex patients move to the next generation of interdisciplinary service.

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