Successful Examples of Integrated Models

Successful Examples of Integrated Models from Across the Country

California: The Integrated Behavioral Health Project (IBHP) is an initiative launched in 2006 to accelerate the integration of behavioral health services into primary care settings in California. IBHP-funded projects have showed statistically significant improvements in patient physical, mental, and general health, and primary care providers reported a lower level of integration between physical and behavioral health at the clinic. For a more detailed analysis, please reference the 2010 IBHP Final Report.

Colorado: Sustaining Healthcare Across Integrated Primary Care Efforts (SHAPE) is a project that brings together Rocky Mountain Health Plans, University of Colorado Denver Department of Family Medicine and the Collaborative Family Health Association.  SHAPE aims to understand the impact of global payment methods on the integration of behavioral health and primary care and test real world applications to inform policy.  Initial projections indicate potential savings of $656 Million on a population of one million patients who have conditions like arthritis, asthma, diabetes or hypertension in conjunction with a behavioral health condition.  More information on SHAPE’s efforts to implement payment reforms and strengthen the foundation for integrated care models can be found here.

Massachusetts: The Massachusetts Child Psychiatry Access Project (MCPAP) is an interdisciplinary healthcare initiative that assists primary care providers (PCPs) who treat children and adolescents for psychiatric conditions. According to MCPAP's Fiscal Year 2012 Statewide Data study, successes in each of their distinct categories have increased as much as 57% since 2005. 

Minnesota: DIAMOND (Depression Improvement Across Minnesota Offering a New Direction) has made great strives towards improving healthcare for people with depression by changing the way care is delivered and how it is paid. Through the Institute for Clinical Systems Improvement (ICSI), medical groups, health plans, employers, and patients have collaborated to develop a better, evidenced-based model for managing depression.

Missouri: Community Mental Health Case Management (CMHCM) is a program that establishes a relationship between a case manager and a patient resulting in face-to-face assistance in a patient’s home or a community setting.  Research on the CMHCM model is beginning to show positive results.  In a 2010 study, CMHCMs were instrumental in lowering health care costs.  Prior to CMHCMs, per user per month costs rose an average of $750.  Since implementation, these costs are falling by an average of $500.  More information on Missouri’s CMHCM model can be found here and the results of the most recent study can be found here.   

North Carolina: ICARE Partnership North Carolina Project seeks to increase access to quality, evidence-based behavioral healthcare services for North Carolinians. A 2008 report entitled From Fragmentation to Integration evaluates the ICARE Partnership North Carolina Project in order to compare outcomes before and after project implementation.

Tennessee: Cherokee Health Systems  has offered an array of comprehensive primary care, behavioral health, and prevention programs and services since the 1960s.  It also has a Primary Behavioral Health Integrated Care Training Acadademy, which provides education and training on their blended model of primary care and behavioral health services.

Texas: Harris County Community Behavioral Health Program is an integrated care program operating in community health centers serving low-income uninsured residents in Houston, Texas. Psychiatry Online provides a 2008 study evaluating the program and found that this program resulted in a 12% improvement in symptoms of depression, self-harm, and alcohol or drug use.

Utah: Intermountain Healthcare is a non-profit health care system serving metropolitan Salt Lake City, which launched a project to integrate mental health care services into primary care practices.  Patients with depression treated in these integration clinics were found to be 54% less likely to visit the Emergency Department.  In addition, patients treated in the Integrated clinics had a 27% lower rate of cost growth.  The success of this program has fostered implementation across the U.S. and is being replicated in Mississippi, Maine, New Hampshire, Oregon, and within local Utah state health agencies.  Results of this model can be found here.

Vermont: Vermont Blueprint for Health is a new way of looking at the practice of medicine and chronic care. Hundreds of healthcare providers are signing on to the Blueprint to learn about innovations, tools, clinical guidelines, and best practices to deliver effective, proactive care, and to involve patients in managing their own chronic conditions.

Washington: Improving Mood – Providing Access to Collaborative Treatment (IMPACT) is a team-based approach that integrates depression treatment into primary care and other medical settings. This model of care was found to be more than twice as effective as usual care for depression, improve physical and social functioning of patients, improve patients’ quality of life, and reduce overall health care costs.  Study results can be found in an Unutzer et al article here and a Katon et al article here.

Examples/Case Studies from Integration

There are several examples of integrated programs from across the country. Case studies of these pioneering programs can be found in the Agency for Healthcare Research & Quality's (AHRQ) 2008 EPC report, "Integration of Mental Health/Substance Abuse and Primary Care."

Information on Integrated Care from the American Psychiatric Association

International Examples

“Beating the Blues”, a program in the UK, has been shown to be evidence based and cost effective in treating anxiety and depression by the primary care provider. Beating the Blues® is the only computerized cognitive behavioral therapy (CCBT) program approved by NICE for treatment of depression.

Better Practices in Collaborative Mental Health Care: An Analysis of the Evidence Base, a 2006 report by the Canadian Collaborative Mental Health Initiative.

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