Assessing cross-sector stakeholder readiness to advance and sustain statewide behavioral integration beyond a State Innovation Model (SIM) initiative

Abstract

Integrated care is recognized as a promising approach to comprehensive health care and reductions in health care costs. However, the integration of behavioral health and primary care is complex and often difficult to implement. Successful and sustainable integration efforts require coordination and alignment both within health care organizations and across multiple sectors. Furthermore, implementation progress and outcomes are shaped by the readiness of stakeholders to work together toward integrated care. In the context of a Colorado State Innovation Model (SIM) effort, we examined stakeholder readiness to advance and sustain partnerships for behavioral health integration beyond the period of grant funding. Partnership readiness was assessed using the Readiness for Cross-sector Partnerships Questionnaire (RCP) in spring 2019. Participants from 67 organizations represented seven sectors: government, health care, academic, practice transformation, advocacy, payer, and other. RCP analyses indicated a moderate level of readiness among Colorado stakeholders for partnering to continue the work of behavioral health integration initiated by SIM. Stakeholders indicated their highest readiness levels for general capacity and lowest for innovation-specific capacity. Five thematic categories emerged from the open-ended questions pertaining to partnership experiences: (a) collaboration and relationships, (b) capacity and leadership, (c) measurement and outcomes, (d) financing integrated care, and (e) sustainability of the cross-sector partnership. Partnering across sectors to advance integrated behavioral health and create more equitable access to services is inherently complex and nonlinear in nature. The RCP usefully identifies opportunities to strengthen the sustainability of integrated care efforts.

H.O.P.E. grows: An academic‐public health partnership to reimagine public health services and increase mental health access among socially vulnerable populations

“…Partnership readiness is shaped by both ability (capacity) and willingness (motivation) of partners to collaborate. In our own practice, we have utilized a readiness diagnostic scale (e.g., Readiness for Cross‐sector Partnership Questionnaire 39 ) to assess the readiness of stakeholders to work together to advance and sustain a health intervention. Given our experience, we assert that other cross‐sector partners can promote partnership effectiveness by systematically assessing partnership readiness and jointly reviewing readiness data to generate strategies for strengthening the partnership 39 .…”

“…In our own practice, we have utilized a readiness diagnostic scale (e.g., Readiness for Cross‐sector Partnership Questionnaire 39 ) to assess the readiness of stakeholders to work together to advance and sustain a health intervention. Given our experience, we assert that other cross‐sector partners can promote partnership effectiveness by systematically assessing partnership readiness and jointly reviewing readiness data to generate strategies for strengthening the partnership 39 . A recommended precursor to administering a partnership readiness assessment is to establish shared partnership values.…”

Moving the needle on health inequities: principles and tactics for effective cross-sector population health networks

“…To maximize the impact of a cross-sector network, partners must assess their individual organizational readiness and ability to participate in the network and its activities [ 24 ]. In considering readiness, network partners should cultivate support and commitment within their organizations for changes that will facilitate the network's work, such as securing funding for staff to devote time to participating in the network, creating changes to workflows to carry out or support the networks activities, and/or incorporating changes to organizational policies to align and reinforce the work of the network [ 25 ].…”