ABSTRACT
The fundamental aim of healthcare reform is twofold: to provide health insurance coverage for most of the citizens currently
uninsured, thereby granting them access to healthcare; and to redesign the overall healthcare system to provide better care
and achieve the triple aim (better health for the population, better healthcare for individuals, and at less cost). The foundation
for this improved system will rest on a redesigned (i.e., sufficiently comprehensive and integrated) system of primary care,
with which all other providers, services, and sites of care are associated. The Patient-Centered Medical Home (PCMH) and its
congeners are the best current examples of the kind of primary care that can achieve the triple aim, if they can become sufficiently
comprehensive and can adequately integrate services. This means fully integrating behavioral healthcare into the PCMH, a difficult
task under the most favorable circumstances. Creating functioning accountable care organizations is an even more daunting
task: this requires new principles of collaborating and financing and the current prototypes have generally failed to incorporate
behavioral healthcare sufficient to meet even the basic needs of the target population. This paper will discuss (1) the case
for and the difficulties associated with integrating behavioral healthcare into primary care at three levels: the practice,
the state, and the nation; and (2) how this looks clinically, operationally, and financially.
uninsured, thereby granting them access to healthcare; and to redesign the overall healthcare system to provide better care
and achieve the triple aim (better health for the population, better healthcare for individuals, and at less cost). The foundation
for this improved system will rest on a redesigned (i.e., sufficiently comprehensive and integrated) system of primary care,
with which all other providers, services, and sites of care are associated. The Patient-Centered Medical Home (PCMH) and its
congeners are the best current examples of the kind of primary care that can achieve the triple aim, if they can become sufficiently
comprehensive and can adequately integrate services. This means fully integrating behavioral healthcare into the PCMH, a difficult
task under the most favorable circumstances. Creating functioning accountable care organizations is an even more daunting
task: this requires new principles of collaborating and financing and the current prototypes have generally failed to incorporate
behavioral healthcare sufficient to meet even the basic needs of the target population. This paper will discuss (1) the case
for and the difficulties associated with integrating behavioral healthcare into primary care at three levels: the practice,
the state, and the nation; and (2) how this looks clinically, operationally, and financially.
- Content Type Journal Article
- Category Practice and Public Health Policies
- Pages 1-8
- DOI 10.1007/s13142-012-0152-5
- Authors
- Shandra M Brown Levey, Department of Family Medicine, University of Colorado Denver School of Medicine, Mail Stop F496, Academic Office 1, 12631 East 17th Avenue, Aurora, CO 80045, USA
- Benjamin F Miller, Department of Family Medicine, University of Colorado Denver School of Medicine, Mail Stop F496, Academic Office 1, 12631 East 17th Avenue, Aurora, CO 80045, USA
- Frank Verloin deGruy III, Department of Family Medicine, University of Colorado Denver School of Medicine, Mail Stop F496, Academic Office 1, 12631 East 17th Avenue, Aurora, CO 80045, USA
- Journal Translational Behavioral Medicine
- Online ISSN 1613-9860
- Print ISSN 1869-6716