| Clinical | ∙ Full-time, on-site primary care behavioral health clinician (1 per 7,500 patients11) ∙ Clinician availability for personal, face-to-face introductions (“warm handoffs”) and consultations ∙ Brief, evidence-supported treatment interventions; other clinical care responsibilities ∙ Intensive training of primary care behavioral health clinicians using standardized protocols for a broad range of psychological and medical problems amenable to behavioral health treatment ∙ Population (panel)–based care using measurement-based, stepped treatment and other resources
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| Operational | ∙ Screening for mental health, substance abuse, and health behavior issues and provider decision support seamlessly integrated into patient flow ∙ Reengineering of practice processes, eg, “warm handoffs,” automated scheduling, referrals ∙ Training providers and staff in behavioral care procedures ∙ Appointment frequency and interval of behavioral health clinician consistent with primary care ∙ Shared, transparent EHR with 2-way notes and access to information ∙ Care management coordination of referrals and information with specialty care as needed
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| Finance | ∙ Brief interventions, which are lower-cost services, provided over shorter episodes of care ∙ Coordination of services and finances to optimize sustainability ∙ Negotiation of appropriate reimbursement ∙ Regular reports of performance, RVUs, and financial data
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