The 40,000 UC Davis Health System patients eligible for mental-health benefits through their health insurance can find the right care at the right price, thanks to an innovative new center at UC Davis Medical Center. For patients, the new Behavioral Health Center means they will have greater likelihood of getting a referral to a high-quality mental-health provider who fits their health-insurance benefits package. For the six-month-old entity known as the UC Davis Health System, the center is a model for other medical-center programs in providing streamlined services. The health system, which came into reality July 1, consists of the UC Davis Medical Center, the School of Medicine and a primary-care network of physicians at 27 sites in Northern California. UC Davis Health System now cares for 180,000 patients, most of whom use a variety of health-care plans. These managed-health-care plans are the driving force behind the move toward more efficient health-care services at UC Davis. Established in August, the new mental-health program pools the expertise of a broad range of mental-health clinicians to coordinate psychiatric services through a single intake point. "What's innovative about the Behavioral Health Center is that it shows us that we can maximize our ability to provide care if we can collaborate with colleagues across departments and across disciplines," said Thomas Anders, chair of the Department of Psychiatry. "For the first time we have total management of a patient's care," rather than a fragmented, hit-or-miss approach as patients get shifted from department to department, he said. The Behavioral Health Center is a cost center, or product line, whose operations are separate from the medical school's various departments. As an autonomous entity, the center has its own staff and programs unique to today's concerns over remaining competitive in an increasingly managed care environment. "I think more and more, as departments begin to think across disciplines to product lines, they can use the Behavioral Health Center as a model," Anders said. "We have a business plan that projects what services are available and how much they cost. We gathered national and local statistics." The conversion was a logical step toward ensuring quality care as primary-care physicians began referring more and more patients on health plans to the UC Davis Health System for mental health services, organizers said. Currently, the Behavioral Health Center counts up to 40,000 patients whose insurance benefits make them eligible for mental health care. "One of the big issues was the realization that the hospital and university were developing more contracts to provide managed care services," said Behavioral Health Center associate director Sue Barton, an assistant professor in the Department of Family Practice. "We realized that we were new to this business, and we needed to change our delivery service to accommodate managed care." Long accustomed to operating as a fee-for-service system, health system leaders saw the need to develop a seamless, cost-effective and collaborative delivery system for patients using health-care insurance. The staff of the Behavioral Health Center includes psychiatrists, psychologists and social workers from the Departments of Psychiatry, Family Practice, Physical Medicine/Rehabilitation, Social Services, Nursing and Employee Assistance. Augmenting this crew are clinicians in rural communities whom the Behavioral Health Center has contracted with to provide services. Services offered through the center cover a broad spectrum, ranging from inpatient care to partial hospitalization to outpatient psychotherapy. Also included in the span of care is medication management, employee assistance, crisis intervention, hospital diversion, 23-hour crisis management and wellness/prevention classes or connection with support groups. The center's services are triggered when a primary-care physician in the UC Davis network--today's gatekeeper for specialty services--calls or faxes the Behavioral Health Center with a request for mental health services for a patient. A clinical case manager directs the patient to the most appropriate facility or provider within the UC Davis system. The process shifts the burden of securing quality services from the primary-care physician to the Behavioral Health Center, freeing up more time for physicians to carefully evaluate what is going on in the lives of their patients. Balancing cost-saving concerns with medical care needs is a key component. Center administrators try to keep expenses in check by spacing out sessions, so that someone who might have been counseled once a week might now be seen less frequently but over a longer period of time, Anders said. Other techniques might include directing a patient to complete "homework assignments," or at-home cognitive therapy exercises, and clustering patients in group sessions.