Key Capacity and Competencies of Practices and Payers to Integrate Behavioral Health and Primary Care

Background:  Principal among the issues of our nation’s healthcare system is the fragmentation of physical and mental health care. Integrating mental health, behavioral health, and substance use services with primary care is essential to achieving the Triple Aim of improving outcomes, lowering cost, and enhancing the patient experience. This presentation will identify the capacity and competencies needed by providers, organizations, and payers to successfully integrate care.

Methods: A team of researchers visited eight integrated primary care clinics in the US for 3 days, observing all aspects of clinical operations and interviewing 8-12 people in a variety of roles at each site. Clinics varied in size, geographic location, type, and years delivering integrated care. 

Findings: Providers and organizations need to have the capacity and competency among their team to identify and treat behavioral health needs, develop workflows for integrated care delivery, establish documentation and communication protocols for information sharing, establish appropriate supervision for behavioral health provider(s), and provide patients with access to behavioral health services.

Payers interested in expanding provider networks or investing in behavioral health services, should identify the following parameters in primary care organizations: shared mission and vision, quality improvement efforts, access to behavioral health services, training, defined roles and responsibilities, workflows, physical space for collaboration, and organized health information technology.

Implications: As primary care clinics transition to integrated care models, providers and organization need to consider key competencies and capacity to successful provide behavioral health services.  Payers can use these as a guide in growing provider networks and establishing new contracts and payment models.