Primary Care and Behavioral Health are Inseparable
Integrated behavioral health is the care that results from a practice team of primary care and behavioral health clinicians, working together with patients and families, using a systematic and cost effective approach to provide patient-centered care for a defined population. This integration is not a small quality improvement project, but a transformative undertaking for the entire practice.
Practices implement integrated behavioral health using a variety of approaches. There is not a single model of integrated behavioral health that will be the right fit for all practices. Different approaches to integrated behavioral health will require different levels of resources, including financial support.
The Building Blocks of Behavioral Health Integration: A New Framework for Alternative Payment Models
This framework of care delivery expectations for integrating behavioral health in primary care aligns expectations across payers, practices, and patients. The framework is intentionally flexible to account for variation in approach to integrating behavioral health. Payers seeking to better support integrated behavioral health in primary care with alternative payment models can utilize this framework for standardized expectations.
How this Framework is Different
- Components of different approaches to integrated behavioral health are separated so that:
- Practices can flexibly choose their approach
- Levels of financial support can be designed to match the selected approach.
- Not specific to a certain model of behavioral health integration.
- Not particular to a specific behavioral health diagnosis, reflects the wide spectrum of behavioral health services that can be provided in primary care.
- A core set of foundational expectations are established.
- Driven by practice-based evidence and experience and refined through input from key informants of diverse roles and backgrounds.
- The use of the building blocks as the overall organizing scheme allows for these behavioral health care delivery expectations to be overlaid on other work to advance primary care practice
The development of this framework was comprised of a multi-step process:
- Selection of a nationally recognized organizing scheme, the building blocks of high-performing primary care
- Development of behavioral health integration milestones for a statewide demonstration project, the Colorado State Innovation Model initiative
- Refinement of behavioral health integration milestones and categorization into different implementation approaches
- Review of other frameworks and models to identify any gaps
- Vetting process with key informants and further refinement of behavioral health integration expectations based on feedback