Behavioral Health Integration in Primary Care: A Review and Implications for Payment Reform

MATHEMATICA-MPR.COM Health care delivery systems have been intentionally reorganizing to become more patient-centered, which means that patients’ preferences, needs, and values help guide clinical decisions. Integrating mental health and substance use services into primary care settings, also known as behavioral health integration (BHI), is a core component of such efforts. To identify where BHI has been successful and where there is still room for improvement, we should have a clear idea of what BHI is and understand what policies exist or are needed to implement BHI. This issue brief provides an overview of BHI, including how it is defined and why it is important for improving patient care. Barriers to effective BHI are noted as well as opportunities to overcome those barriers—particularly in light of recent legislation, such as the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Although important strides have been made in BHI in recent years, providing incentives for BHI through alternative payment models could significantly improve its implementation by removing financial and logistical barriers that remain.