Behavioral Health Primary Care Integration
Health & Medicine Policy Research Group’s Center for Long-Term Care Reform started the Behavioral Health-Primary Care Integration Learning Collaborative in 2015 to guide local advocacy and facilitate practice-level change to improve the lives of people with mental illness and substance use disorder. This Playbook shares the lessons from building and operating a Learning Collaborative and from our three Workgroups. We hope that others can use these as tools to launch or enhance quality improvement and collaborative learning projects.
For people with mental health and/or substance use disorders, behavioral health equity enables recovery. This brief presents an approach for individuals and institutions working in healthcare and public health to engage people with behavioral health conditions around their health and social needs, preferences, and values.
In the Fall of 2015 Health & Medicine distributed a survey to gather input from a broader constituency, beyond the membership of the Learning Collaborative, in order to understand the diverse perspectives on integrated behavioral-primary health care across the state. This presentation shows the results of that survey and some of the key lessons we learned.
This working paper reflects our initial investigation of the current state of best practice in physical and behavioral health integration. The purpose of the paper is to solicit responses from experts and advocates with experience in this field who can advance our understanding of the current state of integration models and guide the direction of the Learning Collaborative.
This paper defines the six criteria and also identifies practices that Learning Collaborative members are implementing that partly or entirely fulfilled each criterion. Rather than defining a strict set of practices that may only work in specific conditions, we focus on the technical assistance needed to operationalize the basic principles of integration. Implied in this approach is that there are many models that fulfill the criteria for integration, and that weak points in a model can be strengthened by borrowing practices from others and carefully incorporating them into the existing framework of service delivery.
This working paper offers a brief history of Medicaid funding for behavioral health, describes home- and community-based services waivers, the Medicaid Rehabilitation Option and its implementation in Illinois, and capitated managed care, all with an eye toward unintended consequences and unexpected, though often predictable, reactions of stakeholders to Medicaid payment policies.
From early planning conversations that set the stage for the Learning Collaborative to recent planning to test new methods for hospital transitional care, data exchange has consistently emerged as a major challenge to implementing integrated models and improving services for people with mental illness and substance use disorder. This policy brief lays out challenges and potential solutions to data exchange in an integrated environment.
Health & Medicine Policy Research Group launched its Behavioral Health-Primary Care Integration Learning Collaborative in 2015. The Learning Collaborative set up a Hospital Transitional Care Workgroup to focus on the potential to improve outcomes for individuals returning to the community after inpatient behavioral health hospital admissions. After many in-depth discussions, the Workgroup began collecting data on hospital transitions. This data collection project concentrated attention on the processes of transitional care, where they breakdown, and how they may be improved. This paper summarizes the Workgroup’s conclusions.
Distilling feedback and insight from Learning Collaborative members, this paper offer our broad perspective on the policy needs for integration, focusing on three key areas related to integrated primary care and behavioral health in Illinois: 1)Building capacity by reforming regulations and reimbursement; 2) Supporting data systems and information exchange, and; 3) Developing an adequate workforce for integrated care.