Coordinating medical and substance use disorder (SUD) services is associated with good health and treatment outcomes but it is not widely practiced. This may be due to a lack of real-world models for coordinating care. This study examined the operational practices associated with a sample of community health centers (CHCs) identified as effectively coordinating SUD services relative to other CHCs. Case studies were used to describe the process of identifying patient need and linking patients with SA treatment services, and to generate propositions about operational approaches for effectively coordinating care. Integrating behavioral health staff within the primary care team was identified as especially critical for facilitating key care transitions. Additional operational approaches that aim to improve care transitions within and across care settings were identified. Future study will be needed to understand the significance of these approaches in terms of health and treatment outcomes. On-going coordination activities among primary care and SUD provided for shared patients remained a challenge for all sites.
