Translational Behavioral Medicine

, Volume 2, Issue 3, pp 364–371 | Cite as

Behavioral health integration: an essential element of population-based healthcare redesign

  • Shandra M Brown Levey
  • Benjamin F Miller
  • Frank Verloin deGruyIII
Practice and Public Health Policies

ABSTRACT

The fundamental aim of healthcare reform is twofold: to provide health insurance coverage for most of the citizens currently uninsured, thereby granting them access to healthcare; and to redesign the overall healthcare system to provide better care and achieve the triple aim (better health for the population, better healthcare for individuals, and at less cost). The foundation for this improved system will rest on a redesigned (i.e., sufficiently comprehensive and integrated) system of primary care, with which all other providers, services, and sites of care are associated. The Patient-Centered Medical Home (PCMH) and its congeners are the best current examples of the kind of primary care that can achieve the triple aim, if they can become sufficiently comprehensive and can adequately integrate services. This means fully integrating behavioral healthcare into the PCMH, a difficult task under the most favorable circumstances. Creating functioning accountable care organizations is an even more daunting task: this requires new principles of collaborating and financing and the current prototypes have generally failed to incorporate behavioral healthcare sufficient to meet even the basic needs of the target population. This paper will discuss (1) the case for and the difficulties associated with integrating behavioral healthcare into primary care at three levels: the practice, the state, and the nation; and (2) how this looks clinically, operationally, and financially.

KEYWORDS

Mental health Behavioral health Primary care Integrated care Collaborative care Healthcare policy 

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Copyright information

© Society of Behavioral Medicine 2012

Authors and Affiliations

  • Shandra M Brown Levey
    • 1
  • Benjamin F Miller
    • 1
  • Frank Verloin deGruyIII
    • 1
  1. 1.Department of Family MedicineUniversity of Colorado Denver School of MedicineAuroraUSA

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