• Daniel D Maeng, Ellen Poleshuck, Tziporah Rosenberg, Amie Kulak, Thomas Mahoney, George Nasra, Hochang B Lee, and Yue Li.
• Department of Psychiatry, University of Rochester Medical Center, 300 Critten Blvd, Box PSYCH, Rochester, NY, 14642, USA. daniel_maeng@urmc.rochester.edu.
• J Gen Intern Med. 2022 Aug 1; 37 (11): 269126972691-2697.

BackgroundBehavioral health (BH) integration in primary care (PC) can potentially improve outcomes and reduce cost of care. While different models of integration exist, evidence from real-world examples is needed to demonstrate the effectiveness and value of integration. This study aimed to evaluate the outcomes of six PC practice sites located in Western New York that implemented a primary care behavioral health (PCBH) integration model.ObjectiveTo assess the impact of PCBH on all-cause healthcare utilization rates.DesignA retrospective observational study based on historical multi-payer health insurance claims data. Claims data were aggregated on a per-member-per-month basis to compare utilization rates among the patients in the PC practice sites that had implemented PCBH to those in the sites that had not yet done so.ParticipantsThe sample included 6768 unique adult health plan members between October 2015 and June 2017 with at least one BH diagnosis code who were attributed to one of the six newly integrated PC practice sites.InterventionsUnder the PCBH integration model, BH specialists were embedded in PC practice sites to treat a wide range of BH conditions.Main MeasuresRates of all-cause ED visits and hospital admissions, along with rates of PC provider and BH provider visits.Key ResultsPCBH implementation was associated with reductions in the rates of outpatient ED visits (14.2%; p < 0.001) and PC provider visits (12.0%; p < 0.001), as well as with an increased rate of BH provider visits (7.5%; p = 0.018).ConclusionsPCBH integration appears to alter the treatment patterns among patients with BH conditions by shifting patient visits away from ED and PC providers toward BH providers who specialize in treatment of such patients.© 2022. The Author(s) under exclusive licence to Society of General Internal Medicine.

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