Special Projects Fund

Grantee Name

Primary Care Development Corporation

Funding Area

Special Projects Fund

Publication Date

July 2021

Grant Amount

$100,000

Grant Date:

November 2018- October 2019

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.

Depression and anxiety disorders are recognized as independent risk factors for the development of diabetes, cardiovascular disease, and poor 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, and vice versa. One innovative 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 are instrumental to improving quality and health outcomes.

In 2018, NYSHealth 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.

Outcomes and Lessons Learned

  • Conducted a case study of a promising integration model, referred to as “the Hub,” a partnership that combines the mental health and substance use disorder services at The Institute for Community Living (ICL) with primary care services at the Community Healthcare Network (CHN) at a single location in East New York, Brooklyn.
  • Interviewed behavioral health and primary care providers and policymakers from all partner organizations involved in the development and implementation of the Hub to establish the basis for blueprint recommendations.
  • Convened an expert panel—comprising more than 40 leaders from primary care, behavioral health, academia, insurance, and finance—and a roundtable to discuss facilitators and barriers to integrating primary care in behavioral health settings.
  • Hosted a forum with 175 stakeholders to discuss recommendations for the blueprint. Stakeholders represented primary care, behavioral health, policymakers, and associations, as well as the New York State Department of Health, Office of Mental Health, and Office of Addiction Services and Supports.
  • Published a final blueprint report, “Closing the Behavioral Health Integration Gap,” to serve as a framework for providers, policymakers, and other stakeholders. The report examined varying models of behavioral health and primary care integration, documented the case study of the Hub, and outlined recommendations at the policy and organizational levels for integrating primary care into behavioral health in New York State. Key recommendations were:
    • Simplify integrated facility requirements (i.e., streamlining State regulatory and licensure requirements);
    • Establish integrated systems to share patient information;
    • Promote a collaborative team-based approach to care (e.g., joint policies and procedures, same-day visits);
    • Ensure bi-directional workforce education (e.g., incorporating cross-discipline training); and
    • Expand financing and reimbursement options for integrated care.
  • Disseminated the report broadly through social media, earned media, PCDC’s website, presentations, and hard-copy mailings:
    • Presented findings at the AcademyHealth’s 12th Annual Conference on the Science of Dissemination and Implementation in Health; and
    • Attracted media coverage, including through the Psychiatric Advisor, which profiled the final report and Integrated Care Forum.

Shortly before PCDC launched its project, the New York State Department of Health issued recommendations as part of its Regulatory Modernization Initiative that addresses needs for integration expansion. Drawing from the recommendations outlined in the blueprint, PCDC has continued to advocate that New York State renew its commitment to regulatory reform to improve and promote behavioral health and primary care integration. An important takeaway from the creation of this blueprint is that there are multiple models that can lead to successfully integrated care. While PCDC’s evaluation of the Hub highlighted important findings and recommendations, PCDC continues to engage with a variety of organizations to identify new avenues to address continued barriers to integration.

Co-Funding and Additional Funds Leveraged: N/A