From the CEO

APA has joined an effort that holds the promise of fundamentally transforming how health care is delivered in this country. We are now a member of a coalition that is working to promote a concept known as the “patient-centered medical (or health) home,” which seeks to ensure that all patients are served by an interdisciplinary team that sees them at a “home” practice where they go for routine care. The goal of the health-homes is not only to significantly improve care, but also to lower costs and ensure that every patient has a say in his or her care.

The health-home idea is a key piece of the health-care reform law enacted last year. Versions of this approach are already under way in pilot projects nationwide, with participation from psychologists locally. (For more information on the health-home concept, see the article “Placing the patient front and center” in the December Monitor.)

Working to make this a reality is the Patient-Centered Primary Care Collaborative’s Executive Committee, which APA has now joined. PCPCC members include the major national associations representing primary-care physicians and nurse practitioners, as well as patient advocacy groups, such as AARP and the National Consumers League. In addition, PCPCC members include chief health insurance players, such as Aetna, Blue Cross/Blue Shield and Kaiser Permanente, and major employers/purchasers, including Fed Ex and IBM.

APA was invited to join the 60-plus-member Executive Committee in October.

Psychology now has a place at the table of that effort. As a member of this executive committee, APA will be able to advance psychology’s role in meeting behavioral health needs at the primary-care level — and bring our long-term goal of fostering integrated health care closer to reality.

Why is it so important for psychology to be central to this model of primary care? That’s where the patients are. Primary-care providers see more patients with mental health problems than any other specialized setting, making primary-care facilities our nation’s de facto mental health system. If psychologists can work closely with primary-care providers and be introduced as a member of a patient’s health-care team, patients won’t have to make a separate appointment to see a mental health professional at a clinic. That would go a long way toward breaking down that barrier of stigma preventing so many people from seeking help.

Just as important, primary-care providers — physicians, nurses and physician’s assistants — need our help, particularly in addressing the behavioral factors tied to chronic health problems, such as smoking, obesity, sedentary lifestyles and lack of compliance to treatment regimens. Psychologists have the expertise to help patients make progress on those problems, instead of letting them get worse and falling into even poorer health.

Research backs the value of this approach.

A review released in December by Paul Grundy, MD, president of the PCPCC, and Kevin Grumbach, MD, of the University of California, San Francisco, found that investing in the patient-centered approach resulted in improved quality of care and patient experiences, and a net saving in total health-care spending on patient care.

APA’s involvement with the PCPCC is also consistent with the association’s Strategic Plan, and its goal of building alliances with organizations that are promoting health reform. As a member of the coalition, we’ll be forming relationships with groups and organizations we’ve never interacted with before.

Of course, we recognize there are obstacles ahead. For one, to fully participate in the home-health movement, psychology practitioners need more training to work directly with primary-care providers. An APA Board of Educational Affairs task force is exploring that issue and will make recommendations for both psychology practitioners and doctoral students who want to work in primary care.

Nonetheless, we are on an exciting road — one that will further APA’s mission of using our practice and research for the public good. For more on the PCPCC, see the website.