A Blueprint for Implementing Co-Located and Integrated Primary Care and Behavioral Health Care
Special Projects Fund
September 21, 2018
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Behavioral health disorders are among the most prevalent health conditions in New York State, with more than 20% of New Yorkers presenting at least one symptom of a mental disorder in a given year, and 10% experiencing mental health challenges significant enough to impede daily functioning.
Additionally, depression and anxiety disorders are recognized as independent risk factors for the development of diabetes, cardiovascular disease, and poorer health outcomes, including mortality. These co-morbidities lead to devastating and costly consequences when the behavioral health conditions of individuals with chronic illnesses go unaddressed. One approach to improve health outcomes and reduce health care costs is to integrate and co-locate behavioral health and primary care services for patients. As New York State pivots from a fee-based to a value-based payment system, integrated and/or co-located services will be instrumental in improving health quality and outcomes. In 2018, NYHealth awarded Primary Care Development Corporation (PCDC) a grant to conduct a case study to develop a blueprint for the effective implementation of a co-located behavioral health and primary care integration model.
Under this grant, PCDC conducted a case study of a promising integration model, referred to as “the Hub,” developed through a partnership between The Institute for Community Living (ICL) and the Community Healthcare Network (CHN). This model integrated ICL’s mental health and substance use disorder services with CHN’s primary care services at a single location in the underserved neighborhood of East New York, Brooklyn. After conducting an in-depth case study of the Hub, PCDC convened a roundtable discussion with stakeholders to present and gather feedback on the preliminary findings. It then prepared a step-by-step blueprint with best practices for implementing a co-located integration model covering four areas: clinical, regulatory, workforce, and facilities finance. To share findings and recommendations, PCDC released a final report summarizing the logistics, challenges, barriers, advantages, and practical lessons that arose from the Hub. As part of a widespread dissemination strategy, PCDC held a statewide convening with providers, policymakers, associations, and other stakeholders to share the case study and final report.