To pilot-test a new framework for integrating behavioral health care services into primary care—developed and disseminated with earlier UHF support—in four primary care medical practices in New York City. Project leaders will provide technical assistance to support the use of the framework, identify implementation challenges, and fine tune the framework based on project findings and results.
Depression and anxiety are common among patients seen in primary care settings, occurring in 20 to 25 percent of patients. These behavioral health conditions have been shown to be independent risk factors for the development of chronic illnesses, such as diabetes and cardiovascular disease, and for poorer overall health outcomes and increased mortality. Most primary care practices, however, lack the ability to identify behavioral health conditions and to provide evidence-based treatments.
In 2015, UHF awarded a grant to Montefiore to develop an evidence-based framework for integrating depression screening and management into primary care settings of different sizes and configurations. The framework, developed by Dr. Henry Chung and published by UHF in June 2016, has been widely disseminated and well-received as a pragmatic approach to integrating behavioral health services into small and medium-sized practices. To fully validate and further refine the framework, Dr. Chung and his team will pilot-test its implementation in four primary care practices of different sizes in New York City. (Supported through a grant from the New York State Health Foundation, Dr. Chung will also pilot the framework in four additional primary care practices upstate.)
Each of the four New York City sites will receive ongoing consultation and support from Dr. Chung and his team, which will conduct three site visits to each provider over 18 months. Sites will receive assistance in performing and evaluating self-assessments, developing goals in each of the components of the framework, identifying data sources and metrics, implementing the framework, and measuring progress. All sites will participate in webinars developed for the project, and three reports will communicate progress among participants, and inform a broader audience of payers, policymakers, and Performing Provider Systems.
A major focus of this project will be assuring that practice changes are sustainable under a variety of value-based payment methods, and providing insights to policymakers and payers on how to realistically support and incentivize broader movement towards more advanced integration.