Clinical, Operational, and Financial Evaluation Practices in Integrated Behavioral Health Care

Public Significance Statement Providing behavioral health services in primary care is a critical step in improving access to behavioral health care, including mental health and substance use treatment. This paper presents the result of a survey of professionals working in primary care with integrated behavioral health services. These healthcare professionals reported on how they determine success with providing integrated behavioral services, and offers recommendations for measuring outcomes to continue to build access to care. Introduction: Integrated behavioral health care is an important pathway to providing whole person care. It is delivered through a transdisciplinary lens and team and funded through complex policies, billing codes, and systems. While the clinical practice of integrated behavioral health care has received attention in the research, less is known about how health care systems demonstrate and evaluate the utility, effectiveness, impact, and longevity of integrating behavioral health into primary care. Method: Health care professionals (N = 145) working in integrated settings were recruited to participate in a metaevaluation about their evaluation practices. Descriptive and regression analyses were used to summarize and evaluate findings on clinical, operational, and financial evaluation practices. Results: There were a variety of types of evaluation practices across the national sample, as well as understanding across professional roles. Findings from the survey, which included primary care providers, behavioral health clinicians, and administrators working in integrated care settings confirmed that there was a lack of knowledge about evaluation and resources necessary to engage in the evaluation of clinical, operational, and financial outcomes. Furthermore, administrators were more likely to know about evaluation practices compared to medical providers and behavioral health providers. The survey also highlighted that organizational barriers to implementing integrated care were an issue across programs. Discussion: Utilizing clinical, operational, and financial evaluation together provide a more comprehensive review of the implementation integrated behavioral health. Real-world implementers and evaluators should consider forming integrated and inclusive evaluation teams, including administrators, medical providers, behavioral health clinicians, patients, and families.