Behavioral Health Integration in Primary Care: Phases of Integration

July 19, 2017

To: CEOs, CMOs, COOs, government affairs staff of WSHA hospitals and health systems and Accountable Community of Health Executive Directors

Please forward to: Hospital and health system staff and clinicians leading work on behavioral health integration

From: Chelene Whiteaker, Policy Director, Washington State Hospital Association

Other contributors included: UW AIMS Center, Community Health Plan of Washington, and the Washington Chapter of the American Academy of Pediatrics
Staff Contact:
Chelene Whiteaker: or 206-216-2545

Subject: New Resources for Providers and ACHs for Behavioral Health Integration into Primary Care

The purpose of this bulletin is to help providers and Accountable Communities of Health (ACH) consider critical elements needed for behavioral health integration as they work to submit applications and plan for implementation of the Medicaid demonstration behavioral health integration project – Project 2A. WSHA, with help from our partner organizations, created a phases of integration template to assist with this work.

Review the template describing the clinical transformation required for primary care providers to integrate mental health and/or behavioral health services. We urge hospitals and health systems to engage with their ACHs on behavioral health integration work. Providers should be in discussion with their ACHs about what needs they have for integration using the allowable frameworks outlined in the Medicaid demonstration.

Behavioral health integration is a major endeavor for primary care providers and systems of care. Resources from the Medicaid demonstration work will assist in driving these important changes through new funding available for planning, training, and implementing behavioral health integration into primary care. This work is expected to start soon, with implementation for participating providers required by October 2019.

One of the greatest opportunities to come out of the Medicaid demonstration is advancing bidirectional integration of behavioral health services. Following these transformations, patients should experience better integration of their care, both clinically and within the various wraparound services they depend on. While clinical behavioral health integration will be supported by the financial integration of Medicaid managed care plans and behavioral health organizations, it is not dependent on this. It is also important to realize that integration of the financing and Medicaid benefits will not necessarily result in changes to patient care without on the ground transformation at the practice level.


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