Evaluation of a Continuum-Based Behavioral Health Integration Framework Among Small Primary Care Practices in New York State: Practice and Policy Findings and Recommendations
Advancing Primary Care
April 5, 2019
This issue brief, co-funded by United Hospital Fund (UHF) and the New York State Health Foundation (NYSHealth), summarizes the evaluation results of an effort to integrate behavioral health screenings into 11 small primary care practices in New York.
Integrating screening, diagnosis, and treatment of common behavioral health conditions—such as depression, anxiety, and substance use—into primary care is widely acknowledged as a pressing goal, but has remained a significant challenge, especially for smaller, resource-constrained practices that provide much of New York City’s and State’s primary care.
In 2016, a team led by Dr. Henry Chung of Montefiore Health System and Dr. Harold Pincus of New York-Presbyterian Hospital published the report, Advancing Integration of Behavioral Health into Primary Care: A Continuum-Based Framework. To build on this work, funding from UHF (for six New York City practices) and NYSHealth (for five practices throughout the State) supported the launch of a project involving 11 small practices in New York City and State. This diverse group of highly motivated practices—all with five or fewer primary care providers—is working to move from early to advanced stages of integrated practice.
The project team generated a series of issue briefs to summarize their findings:
The first issue brief described how the 11 selected practices planned to implement and integrate behavioral health services, as well as their 6-month goals, and presented results from a baseline readiness assessment for behavioral health integration.
The second issue brief offers insights, at the midway mark, from a year-long effort to move from theory to real-world practice using that incremental approach.
This issue brief, the last of the series, highlights the evaluation results of this project. Among a representative sample of practices, depression screening rates improved from a baseline of 25% to 33%, and depression detection rates increased by 78%. There were also improvements in referrals, tracking patients, and greater information-sharing between primary care doctors and behavioral health specialists.