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Executive Summary

Nearly one in five U.S. adults live with a diagnosed behavioral health condition , but patients often struggle to access the care they need. Behavioral Health Integration (BHI) has emerged as a powerful, evidence-based method to deliver high-quality behavioral health care in primary care and other medical settings. Given that 80% of Americans saw a primary care physician in the past year, BHI can remove the burden from patients by connecting them to behavioral health services where they are already receiving care. Integrating behavioral health into primary care creates a more holistic and patient-centered system of care where behavioral and physical conditions are treated concurrently under a comprehensive care plan leading to better health outcomes.

Despite the benefits of BHI, the healthcare system has struggled to scale and sustain integrated models due to challenges stemming from industry misalignment, fragmentation, and lack of financial investment.

Provider organizations can face barriers to implementing BHI in their practices due to high upfront costs, necessary technological investments, and the additional time and effort required of already busy clinicians for training and workflow development. Once implemented, providers often report that complexities in navigating billing and reimbursement can threaten their ability to sustain BHI programs.

Collaboration across providers, payers, government agencies, and other stakeholders can help address the barriers to BHI by providing clarity, improving administrative processes, and increasing financial investment. Opportunities include improving engagement and alignment across health plans, establishing statewide spending measurements and benchmarks, and increasing access to training and technical assistance. This paper provides case studies on how health plans can build effective partnerships with provider organizations to support BHI as well as how stakeholders can work together to develop a statewide definition of BHI that can advance greater alignment and investment across policy, industry practices, and other integration-focused initiatives.

Behavioral health integration represents an opportunity to create a more comprehensive, person-centered system of care that concurrently identifies and treats behavioral health alongside medical conditions. Through stakeholder collaboration, aligned industry investment, and supportive policymaking, the healthcare system can address barriers to scaling and sustaining BHI models, increasing patient access to high-quality, evidence-based care.