Behavioral health in the Department of Defense Patient-Centered Medical Home: history, finance, policy, work force development, and evaluation

Integrating behavioral health services into the patient-centered medical home (PCMH) is an important component for meeting
the goals of easy access, whole person, coordinated, and integrated care. Unlike most PCMH initiatives, the Department of
Defense’s (DoD) Military Health System (MHS) launched its PCMH initiative with integrated behavioral health services. This
integration facilitates the MHS’s goal to meet its strategic imperatives under the “Quadruple Aim” of (1) maximizing readiness,
(2) improving the health of the population, (3) enhancing the patient experience of care (including quality, access, and reliability),
and (4) responsibly managing per capita cost of care. The MHS experience serves as a guide to other organizations. We discuss
the historical underpinnings, funding, policy, and work force development strategies that contributed to integrated behavioral
healthcare being a mandated component of the MHS’s PCMH.