EHS Medical Group Teams With Anthem Blue Cross To Address Unmet Behavioral Health Needs For Medi-Cal Members

LOS ANGELES -- Oct. 19, 2010 -- EHS Medical Group, the largest Medicaid Accountable Care Organization in California, today announced a collaborative initiative with Anthem Blue Cross' State Sponsored Business, the state's largest provider of Medi-Cal benefits in California, to address unmet behavioral health needs in the primary care setting. The program, called the Primary Care Behavioral Health Project, will support behavioral health needs in Sacramento County; specifically, undiagnosed mental health conditions and mental health conditions associated with chronic disease in Medi-Cal insured patients served by Sacramento Family Medical Clinic, an EHS Medical Group provider.

According to the National Association of Psychiatric Health Systems, behavioral health care saves money, saves lives, and serves community interests. The continuity inherent in primary care makes early detection possible. While many behavioral health issues are first diagnosed by a primary care physician, research indicates that only one-half of primary care patients with a behavioral health condition are diagnosed.

By increasing psychiatric services, and providing additional training for primary care physicians in the diagnosis and treatment of certain mental health conditions, the Primary Care Behavioral Health Project aims to prevent complications and improve health outcomes associated with specific diseases. Patients will benefit from having their behavioral health issues recognized earlier and by receiving treatment from providers with enhanced skills. Primary care providers will benefit from having their clinical skill sets enhanced, allowing them to handle complex behavioral health issues with greater confidence. Finally, industry stakeholders will benefit from improved chronic care management, decreased anxiety-related emergency room use and a reduction in costly pursuits of physical explanations for non-physical conditions.

"Undiagnosed behavioral health issues cause additional patient suffering and have a negative impact on their overall health.  Also, because these patients often end up using more health care resources, such as emergency rooms, unmet behavioral health needs increase health care costs," said Dr. Gilbert Simon, Creator of the Primary Care Behavioral Health Project, and Sacramento Family Medical Clinic and EHS Medical Group Physician. "Greater understanding, timely diagnosis and treatment of certain behavioral issues - especially those that co-occur with certain chronic diseases, such as diabetes - in the primary care setting may have significant long-term benefits for patients and for the industry."  

Behavioral health issues often co-occur with other health conditions, complicating treatment and raising overall medical costs. For example, according to the National Business Group on Health's Center for Prevention and Health Services, patients with diabetes and co-morbid depression have health care costs that are more than four times higher than those without co-morbid depression. Although integrated treatment has been shown to lead to dual recovery and reduced costs, mental disorders in people with chronic health conditions still frequently go undiagnosed and untreated.

"Behavioral health issues are a big problem and patient needs are not being met by the public safety net; it's time for the traditional independent providers to step up and meet those needs," said Peter Winston, Executive Vice President of EHS Medical Group. "EHS Medical Group is constantly identifying new opportunities where we can partner with our Health Plans and physicians to improve the quality and delivery of patient care. Dr. Gil Simon is a medical visionary, and we believe that the Primary Care Behavioral Health Project will benefit both patients and the health care system in the communities where it's implemented."

Anthem believes that support for improved integration of medical and behavioral health services is fundamental to help ensure their Medi-Cal members are accessing the right health services in the appropriate setting.  "Improving the lives of patients with mental health conditions means ensuring that primary care physicians are appropriately supported in the diagnosis and treatment of those conditions," said Keith  Isenberg, MD, medical director for Anthem Blue Cross. "This program has the potential to change the way our members address behavioral health issues and could prove to be valuable to our members, the community and to the health care industry."


About the Primary Care Behavioral Health Project

The Primary Care behavioral Health Project is aimed at supporting the diagnosis and treatment of mental health conditions in patients served by Sacramento Family Medical Clinic and EHS Medical Group primary care physicians. Starting in June, 2010, groups in the Sacramento area added the services of a half time psychiatrist to improve the identification and treatment of children with ADHD. There are plans to expand the project to improve the treatment of diabetic patients with depression, by providing primary care physicians with tools for depression diagnosis and monitoring of treatment. The project is supported and partially funded by Anthem Blue Cross' State Sponsored Business.


About EHS Medical Group
Launched in 1990, EHS Medical Group is a medical professional corporation and integrated health care delivery system that focuses on government programs, organized labor and specialty IPAs. Our physician-centric accountable care model promotes growth and sustainability for individual physicians by providing access to a robust offering of products, services and management tools. By empowering physicians, supporting the practice of evidence-based medicine and expanding and integrating as a network, we strive to deliver efficient, cost-effective and high-quality coordinated care to members in California, and throughout the country. For more information, visit

About Anthem Blue Cross         
Anthem Blue Cross is the trade name of Blue Cross of California.  Anthem Blue Cross Partnership Plan is the trade name of Blue Cross of California Partnership Plan. Anthem Blue Cross and Anthem Blue Cross Partnership Plan are independent licensees of the Blue Cross Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc.  The Blue Cross names and symbols are registered marks of the Blue Cross Association.