Introduction: Psychosocial factors are known to impact diabetes outcomes. The Diabetes Behavioral Health Integration Program (BeHIP) offers integrated psychosocial assessment and care for people with diabetes at a large health system in Southern California. Objective: To describe referral, participation, and reimbursement patterns of the BeHIP.
Methods: BeHIP services are provided by licensed clinical psychologists co-located with physicians and CDCESs in the Division of Endocrinology. Patients identified for BeHIP support are referred via warm hand-off or through their EHR and undergo an individualized assessment followed by individual psychotherapy when indicated. Patients with severe mental illness or concerns unrelated to diabetes are referred out to appropriate services. Data was collected and analyzed via an EHR extraction. Comparisons between those who did versus did not complete at least 1 BeHIP visit were tested by unpaired t-test for continuous data or Chi Square test for categorical data.
Results: Of 953 BeHIP referrals placed between 2017 and 2023, 45% participated in the program. Individuals with T2D (48%), T1D (45%), GDM or other diagnoses (7%) were referred, with no associations between diabetes type and participation. Compared to non-participants, participants were older [55.4±17.1 vs 53.2±17.6] * and referred by an endocrinologist [75.6% vs 60%] *. While the majority of BeHIP referrals were women (70%), gender did not impact the participation status of those referred (47% vs 41%, for women and men, respectively) ≠. Finally, 78% of Health and Behavior CPT codes billed for BeHIP services were reimbursed by insurance, with the reimbursement rate varying widely across insurance plans.
Conclusion: This project provides real-world information to guide our understanding of factors that can impact participation and financial viability of clinical programs targeting psychosocial and behavioral needs within routine diabetes care. *p≤.05, ≠p≥.10
E.C. Soriano: None. A.L. Fortmann: None. N. Nouhi: None. A. Philis-Tsimikas: Advisory Panel; Dexcom, Inc., Lilly Diabetes, Novo Nordisk, Sanofi, Medtronic, Bayer Inc.
