When Frontline Practice Innovations Are Ahead of the Health Policy Community: The Example of Behavioral Health and Primary Care Integration

Abstract

Innovation in health care delivery often far outpaces the speed at which health policy changes to accommodate this innovation. Integrating behavioral health and primary care is a promising approach to defragment health care and help health care achieve the triple aim of decreasing costs, improving outcomes, and enhancing patients' experiences. However, the problem remains that health policy does not frequently support the integration of care. This commentary describes some of the reasons policy falters as well as potential opportunities to begin to influence health policy to better support practices that take an integrated approach to health care. (J Am Board Fam Med 2015;28:S98 -S101.)

Topical Review: Building Competency: Professional Skills for Pediatric Psychologists in Integrated Primary Care Settings

“…Our ability to produce and contribute to research is one clear way in which our field differentiates itself from other helping professions. As the medical climate shifts with legislation such as the ACA, there is mounting emphasis on accountability and outcome measurement (Miller, 2015). Increasingly, psychologists are being asked to demonstrate effectiveness of their work, not only to secure their roles on medical teams, but also to justify payment by insurance companies who are increasingly requiring measurable effectiveness of psychological treatment.…”

“…Although there is a need for integrating behavioral health into primary care, legislation is not sufficiently in place to support the growth of pediatric psychologists in the field (Miller, 2015).…”

Development and validation of a measure of primary care behavioral health integration.

“…This care may address mental health and substance abuse conditions, health behaviors (including their contribution to chronic medical illnesses), life stressors and crises, stress-related physical symptoms, and ineffective patterns of health care utilization. (Peek & the National Integration Academy Council, 2013) Integrated care, supported by a growing body of evidence, has become increasingly mainstream (Miller, 2015). Examples of behavioral health and primary care services in family medicine residency practices have existed for more than 30 years (Blount & Miller, 2009).…”

Advancing Care Together by Integrating Primary Care and Behavioral Health

“…Three invited commentaries on leadership, policy, and practice assistance 27,28,29 conclude the supplement offering interpretations and suggestions about next steps, which are urgently needed to continue to move forward toward the integration of behavioral health and primary care.…”