Business Models

Integrated care business models are being developed and tested in both public and private sectors. 

The Integrated Care Resource Center is a national initiative of the Centers for Medicare & Medicaid Services (CMS) to help states improve the quality and cost-effectiveness of care for Medicaid’s high-need, high-cost beneficiaries. State Options for Integrating Physical and Behavioral Health Care (PDF - 300KB) is a Technical Assistance Brief published in October 2011. This analysis explores state options for integrating physical and behavioral health services within managed delivery systems, including examples of current state programs and critical considerations for implementation. 

AHRQ, through its Evidence-based Practice Centers (EPCs), sponsors the development of evidence reports and technology assessments to assist public- and private-sector organizations in their efforts to improve the quality of health care in the United States. One such report is Integration of Mental Health/Substance Abuse and Primary Care (No. 173).  This report describes models of integrated care used in the United States; assesses how integration of mental health services into primary care settings or primary health care into specialty outpatient settings impacts patient outcomes; and describes barriers to sustainable programs, use of health information technology (IT), and reimbursement structures of integrated care programs within the United States. 

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Oregon’s Alternative Payment Methodology (APM) model may be a promising approach to financing and sustaining behavioral health (BH) integration efforts, suggests Deborah Cohen, PhD, in an April, 2015 blog post in Health Affairs Blog entitled “Addressing Behavioral Health... Read more