The Chicago Forum for Justice in Health Policy: Learning and Advocacy for Behavioral Health–Primary Care Integration - Health & Medicine Policy Research Group

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The Chicago Forum for Justice in Health Policy: Learning and Advocacy for Behavioral Health–Primary Care Integration

Jun 25, 2018

On Monday, June 25 Health & Medicine hosted a forum to share lessons from members of our Behavioral Health-Primary Care Integration Learning Collaborative. The Learning Collaborative has just completed three years of work, and released a Playbook that describes the knowledge gained from providers, advocacy groups, people with lived experience, and a managed care provider as we attempted to find a way to solve ongoing challenges to integration.

The forum, held at Loyola University Regents Hall, had a particular focus on hospital transitional care, financial sustainability, and data exchange from our collaborative members, and as well as informing a local advocacy agenda and practice-level changes to improve the lives of people with mental illness and substance use disorder.
Forum resources:

Integrating the Integrators: What are we all learning about behavioral health-primary care integration?
Directions of Integration
Behavioral health integration commonly refers to models that provide behavioral health services in primary care settings. We chose to focus on the “reverse” direction—integrating primary care into behavioral health settings. In making that decision, we were influenced by the work of Martha Gerrity who points out that the evidence base for integrating behavioral health into primary care, especially for people with depression and anxiety, is far more advanced than for the other direction, integrating primary care into behavioral health settings. Research on integrating primary care into behavioral health—which shifts the focus of integration to individuals with severe mental illness (SMI) and substance used disorders (SUD) who are more likely to present at behavioral health providers than at primary care offices—is more sparse. Gerrity notes that existing research on behavioral health integration for people with SMI or SUD “do[es] not describe the models or target populations in enough detail to assist policymakers with implementing the models.”

Because a major goal of the Learning Collaborative is to assist both providers and policymakers to implement integration strategies (in partnerships with payers and consumers), we felt called to address this gap in research and practice. With our charge to generate learning among our members to further the integration of primary care into behavioral health, our next move was to develop criteria for assessing progress toward integration.

What do we mean by “integrating the integrators”? 
When we first convened the Learning Collaborative, we knew we needed to build a sense of common purpose among our members, who represent behavioral health centers, primary care centers, hospitals and Blue Cross Blue Shield, which is both a funder of the collaborative and a managed care provider. We are also aware that in the Chicago area, a number of other learning collaboratives are concurrently studying behavioral health and primary care integration, with different configurations of stakeholders and purposes. During a time of budget crisis and political uncertainty, we believe it is more important than ever to offer an opportunity for all of us to share what we are learning, and look for ways to align around what we know; what we still need to know; and what we can ultimately work to fix together.

Goals for the Forum
In addition to sharing our three years of lessons and bring to the conversation other providers and payors doing similar learning, we also want to use this moment of transformation to hear from State of Illinois agency staff about the implications of the recently approved 1115 waiver and the upcoming implementation of the Illinois Health Homes program. Looking across systems, stakeholders and strategies will provide us with new ideas, renewed energy, and allow us to shape policy recommendations for the next phase in our respective approaches to bring health equity to people with lived experience of mental illness.

Thank you to our co-sponsors, Loyola University’s Beazley Institute for Health Law and Policy and the Civitas ChildLaw Center