Integration of behavioral health services in primary care settings: What are health plans doing?

Objective: Integration of behavioral health services with primary care has been shown to improve care delivery. Our objective was to examine health plan policies that may encourage or discourage integration of behavioral health services into primary care. Methods: Data are from the third round of a nationally representative, in-depth telephone survey of executives at private US health plans in 2010 (89% response rate). Data include 351 commercial health plans in 60 market areas across the country reporting on 939 products. Data are weighted to present national estimates.

Results: Integration of behavioral health services with primary care varies by the ways in which health plans organize behavioral health services. Plans that manage behavioral health services themselves are more likely to reimburse for behavioral health specialists co-located in primary care practices than plans that contract with a specialty behavioral health organization to manage behavioral health care or plans that own a specialty behavioral health organization. Specialty and hybrid plans are more likely to reimburse for case managers to address behavioral health conditions in primary care and are more likely to provide increased payments for care delivered in integrated settings.

Conclusions: Health plans encourage coordination of behavioral health specialists and primary care through direct service provision by the plans. Co-location of behavioral health specialists in primary care is reimbursed by health plans and is more common in internally managed plans. As medical homes and ACOs become more common it will be important to track health plan support of behavioral health services.