Advancing Implementation of Primary Care and Behavioral Health Service Integration for Patients with Complex Care Needs


Integrating physical and behavioral health services can be an effective strategy for improving the quality of care and patient outcomes for vulnerable populations. However, many community-based primary care sites lack the capacity, skills, and infrastructure to make integrated care a reality. Implementation ability varies by practice size, location, and resource availability; in addition, policy and payment strategies can either enable or hinder sustainable implementation of integrated care. In a previous project supported by the United Hospital Fund, Dr. Harold Pincus developed an integration framework that defined key domains of integrated care and created a roadmap for implementation in various community-based primary care settings. Building on the above framework, Pincus and his team, working in collaboration with Henry Chung, M.D., chief medical officer of the Care Management Company at Montefiore Medical Center, will identify challenges that primary care practices serving low-income populations face in trying to integrate behavioral health care with physical health care and highlight corresponding state-level policy strategies to implement and sustain integrated care models in these practices. The team will focus on three types of care settings: 1) small, independent primary care sites; 2) mid-size, aggregated, or networked primary care practices; and 3) large, multispecialty primary care sites. The researchers will conduct a literature review and interview key personnel at primary care practices about barriers and successful strategies. An additional set of interviews with Medicaid officials and policy experts will help identify needs, policies, and incentives to support integrated care at the state level, with a particular focus on how Medicaid and managed care policy can facilitate integration. Findings from this research will assist primary care practices, delivery system leaders, and state policymakers with plans to integrate behavioral and physical health care services for Medicaid enrollees and other vulnerable populations.

Grant Details

Grantee Organization:
Research Foundation for Mental Hygiene, Inc.
Principal Investigator:
Harold Pincus, M.D.
Award Amount:
Approval Date:
November 14, 2017

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