PT  - JOURNAL ARTICLE
AU  - Blasi, Paula R.
AU  - Cromp, DeAnn
AU  - McDonald, Sarah
AU  - Hsu, Clarissa
AU  - Coleman, Katie
AU  - Flinter, Margaret
AU  - Wagner, Edward H.
TI  - Approaches to Behavioral Health Integration at High Performing Primary Care Practices
AID  - 10.3122/jabfm.2018.05.170468
DP  - 2018 Sep 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 691--701
VI  - 31
IP  - 5
4099  - http://www.jabfm.org/content/31/5/691.short
4100  - http://www.jabfm.org/content/31/5/691.full
SO  - J Am Board Fam Med2018 Sep 01; 31
AB  - Introduction: Behavioral health (BH) integration has been proposed as an important strategy to help primary care practices meet the needs of their patient population, but there is little research on the ways in which practices are integrating BH services. This article describes the goals for BH integration at 30 high-performing primary care practices and strategies to operationalize these goals.Methods: We conducted a qualitative analysis of BH integration at 30 US primary care practices that had been selected for the Learning from Effective Ambulatory Practices (LEAP) project following an interview-based assessment and rating process. Data collection included formal and informal interviews with practice leaders and staff, as well as observations of clinical encounters. We used a template analysis approach to thematically analyze data.Results: Most LEAP practices looked to BH integration to help them provide timely BH care for all patients, share the work of providing BH-related care, meet the full spectrum of patient needs, and improve the capacity and functioning of care teams. Practices operationalized these goals in various ways, including universal BH screening and involving BH specialists in chronic illness care. As they worked toward their BH integration goals, LEAP practices faced common challenges related to staffing, health information technology, funding, and community resources.Discussion: High-performing primary care practices share common goals for BH integration, as well as common challenges operationalizing these goals. As US residents increasingly receive BH services in primary care, it is critical to remove barriers to BH integration and support primary care practices in meeting a full spectrum of patient needs.