Advancing Behavioral Health Integration for Small Primary Care Practices: Progress, Emerging Themes, and Policy Considerations

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Bringing behavioral health services into primary care is increasingly recognized as an important component of high-quality care, but for many small and medium-size practices, the new routines and resources needed to do so move that goal out of reach. The introduction of a “continuum-based framework” for behavioral health integration-a roadmap to phasing in critical BHI functions in eight specific domains, to foster systematic diagnosis and treatment of depression, anxiety, and substance use-was a major step forward in changing that scenario; that framework, developed by a team led by Drs. Henry Chung, of Montefiore Health System, and Harold Pincus, of New York-Presbyterian Hospital, with grant support from UHF, was the subject of a 2016 report, Advancing Integration of Behavioral Health into Primary Care: A Continuum-Based Framework.

This new report, the second in a series of three, offers insights, at the midway mark, from a year-long effort to move from theory to real-world practice using that incremental approach. With additional funding from UHF and new funding from the New York State Health Foundation, the Framework team has been working with 11 provider groups throughout New York City and State, providing guidance, tracking progress, and absorbing lessons about the implementation process. The experiences of three of those practices are highlighted here, along with one payer's efforts to support behavioral health integration; emerging policy and financial considerations are also presented.