LIFECORE Health Group's Integrated Care Delivery Model
Need: A model that integrates primary care and mental health for rural residents in northeast Mississippi.
Intervention: LIFECORE Health Group created an integrated care delivery model that meets the mental health and primary care needs of children and adolescents who suffer from severe emotional disturbances and adults who suffer from chronic behavioral health disorders or chemical dependency.
Results: LIFECORE's integrated model has become a sustainable approach to health, reducing the amount of hospital stays and increasing patient compliance, utilization of LIFECORE services, health outcomes of patients with chronic diseases, and facility revenue.
In northeast Mississippi,
the number of patients per primary care provider far
exceeded the national average. This was directly
affecting patients at LIFECORE Health
Group's mental health centers. Sixty-eight percent of
LIFECORE patients had co-occurring physical illness.
Patients' medical conditions were not improving at the
rate necessary to gain full health.
In 2012, LIFECORE created the state's first integrated
care delivery model. Patients around the 7-county
designated Health Professionals Shortage Areas (HPSAs)
now have full access to both primary and mental
healthcare in one location.
LIFECORE primarily serves children and adolescents who
suffer from severe emotional disturbances and adults who
suffer from chronic behavioral health disorders or
chemical dependency. Their goal is to help patients
function independently while lowering the amount of
psychiatric hospital admissions or placements in
long-term institutions. With this integrated care
delivery model, LIFECORE patients can connect with both
behavioral health and primary care services services from
As a regional community mental health center, LIFECORE is
supervised by a regional commission under the Mississippi Department of
Mental Health. LIFECORE partners with the University of Southern
Mississippi to recruit nurses who gain dual
certification as a psychiatric nurse and a nurse
practitioner, a USM program funded by Health Resources
and Services Administration (HRSA). This helps bridge the
gap for the shortage of psychiatrists and has added to
the LIFECORE workforce. The Mississippi Rural Health
Association is also a LIFECORE partner and supports
The 220 LIFECORE staff include health professionals who
work together to meet both physical and behavioral health
needs of patients. The following are licensed and
clinical staff who cross-refer patients.
Family Practice Physicians
Family Nurse Practitioners
Psychiatric Nurse Practitioners
RNs and LPNs
Master's Level Therapists
Day Treatment Therapists
Community Support Specialists
The following services are offered as a part of
LIFECORE's integrated care delivery model:
Primary residential support
Transitional residential support
Assertive Community Treatment (ACT)
A mobile crisis response team
Additional LIFECORE services:
Onsite pharmacy – Allows patients the convenience of
picking up their prescriptions after an appointment.
health pre-assessments – Patients can take online
to evaluate their risk of anxiety, depression,
borderline personality disorder, and attention-deficit
– A LIFECORE transportation service that offers
patients rides to and from appointments at low cost.
LIFECORE Health Group's integrated care delivery model
has seen significantly positive outcomes in their
6,000-person patient population. LIFECORE has been
successful in their goal of becoming a "one-stop shop"
for meeting behavioral health, primary care, and
pharmaceutical needs. Integrated treatment plans and
same-day referrals are helping patients gain full health,
physically and mentally.
Reimbursement rates for these services are still limited,
but the integrated approach has allowed the model to
attain sustainability. Patient data is tracked and
collected within an electronic medical record system that
is shared between behavioral and primary care providers.
Data from these records show the following positive
results since the implementation of the integrated care
The number of primary care follow-up appointments has
increased while the number of acute hospital stays has
decreased at the region's psychiatric hospital (from 608
in 2012 to 574 in 2015)
Patient compliance rates have improved.
Health outcomes of patients with chronic diseases
Patient numbers and the utilization of LIFECORE
services have increased.
More patients are taking advantage of care
coordination service and educational opportunities.
LIFECORE has experienced an increase in revenue due
to the model's efficiency and an increase in patient
numbers. Because of this, LIFECORE is planning on growth
and expanding services and locations in the near future.
CMS reimbursements restrictions prevented Medicaid
patients from getting primary care and behavioral health
services on the same day. With the passing of the
21st Century Cures Act, the restrictions are
expected to soften. This will expedite reimbursement of
all same-day services LIFECORE offers, provide additional
resources for suicide prevention, and expand crisis
intervention training for first responders.
Because of the difference in medical terminology used
by psychiatrists and primary care staff, getting everyone
to use the "same language" has been a challenge. An
effort is currently being made by both professions to
learn the other's terminology and use it when
appropriate, lessening the communication barriers.
Other challenges include the EHR merge and
maintaining HIPAA compliance, discussions surrounding
"who owns the client," shifts in the economy, and
LIFECORE Health Group was the first community mental
health system in the state to adopt an integrated care
delivery model. They regularly present about their
methodology and serve as a resource for those who have
replicated the model. Below are some of their key
In most cases, primary care staff are relieved to
have behavioral health specialists readily available.
Capitalize on this desire for primary care to lean on
behavioral health staff and vice versa by pitching the
integrated service delivery model.
In many settings, services offered by behavioral
health adjuncts (contracted professionals or students who
are brought in from outside of the facility) are
non-billable and can be promoted as a free service to
patients. Even if you have your own behavioral health
staff onsite, a working relationship with adjuncts can be
helpful when there is an overflow of behavioral health
needs within your facility.
An integrated service delivery model like this one
requires long-term commitment. In many cases, behavioral
health services are hard to locate, too small, and not
well promoted. True integration requires constant
collaboration and communication, with behavioral health
promoted alongside of primary care services.
In regards to integration between electronic medical
records, collaboration between providers, clinicians, and
pharmacy is crucial in the accurate and useful
synchronization of patient records.
Please contact the models and innovations contact directly for the most complete and current information
about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The
programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
community should consider whether a particular project or approach is a good match for their community’s
needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep
in mind that changes to the program design may impact results.