Making progress on integration of behavioral health care and other medical care

Integrated primary care
Editor's note:

This white paper is part of the USC-Brookings Schaeffer Initiative for Health Policy, which is a partnership between Economic Studies at Brookings and the University of Southern California Schaeffer Center for Health Policy & Economics. The Initiative aims to inform the national health care debate with rigorous, evidence-based analysis leading to practical recommendations using the collaborative strengths of USC and Brookings. We gratefully acknowledge financial support from The Commonwealth Fund.

Integrating behavioral health into primary care has long been a goal of health policy makers throughout the health system. Primary care settings are touched by most people and offer a setting that can be less stigmatizing and easier to access than mental health settings. They also offer opportunities to address the range of health and mental health conditions that frequently travel together. More recently, attention to leveraging the supply of primary care practices to address apparent shortages of behavioral health providers in various locations and treatment settings has given still greater import to efforts to integrate behavioral health and primary care services.

The evolution of the health care system along with important changes in the financing and regulation of mental health care open new opportunities to drive integration of care specifically and improved behavioral health care more generally. In this paper, we offer strategies to leverage existing programs like Medicare Advantage (MA), the Medicare Shared Savings Program (MSSP), Medicaid’s Early and Periodic Screening Diagnostic and Treatment Program (EPSDT), and Medicaid Managed Care Organizations (MMCOs). The key elements of our proposed strategy focus on enhanced performance metrics, linking performance to financial and market consequences, and greater attention to enforcing existing program requirements to integrate care and make behavioral health care more robust overall.

Read the full white paper here.

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  • Acknowledgements and disclosures

    The authors thank Sherry Glied, John O’Brien, and Nathaniel Counts for their substantive contributions to this paper. They also thank Karina Aguilar for excellent research assistance and Caitlin Rowley for assistance with project oversight and editorial support.


    Vikki Wachino is an advisory board member of Brace Health. The authors did not receive financial support from any firm or person for this article or from any firm or person with a financial or political interest in this article. Other than the aforementioned, the authors are not currently an officer, director, or board member of any organization with a financial or political interest in this article.