Cost-Savings Analysis of Primary Care Behavioral Health in a Pediatric Setting: Implications for Provider Agencies and Training Programs

This study investigated economic savings associated with primary care behavioral health (PCBH) in a diverse sample of 248 pediatric patients seen at a Federally Qualified Health Center. We sought to determine the (a) overall cost savings from PCBH and (b) incremental costs and savings of services provided by doctoral trainees versus full-time behavioral health employees (BHEs). Data were extracted from patient medical records for the 2015-2016 training year. We calculated the per-patient costs for BHEs (n = 5; served 223 patients) and trainees (n = 2; served 25 patients) from administrative data. Savings associated with PCBH were computed based on reductions in monthly health care charges after versus before the initial PCBH visit for each patient. There was a significant reduction in health care charges after an initial PCBH visit, with an overall (i.e., average across provider types) net savings of $38 per patient. Stated differently, each dollar spent on PCBH returned approximately $1.16 in reduced health care charges. There was no significant difference in cost-savings between BHEs and trainees. Uncertainty in several key study parameters (i.e., BHE salary, changes in health charges) may have influenced the results. These findings suggest that PCBH services with pediatric patients hold promise in terms of economic sustainability, including when trainees are involved in service delivery. Implications of the study findings for policymakers, provider agencies, and doctoral training programs in psychology are discussed. Implications for Impact Statement This study suggests that including social workers and psychology trainees in pediatric primary care services can result in savings on overall health care expenses. Trainees showed promise in producing the same savings as full-time employees.