Integrated Healthcare: Opportunities for Research

Integrated healthcare is essential to improving healthcare delivery and outcomes in the United States.  It is estimated that at least 25% of patients visiting a primary care physician have a diagnosable mental disorder and that as many as 85% of visits to the primary care doctor have a psychosocial antecedent, but care for behavioral health disorders is not well supported in primary care.  Instead, people with behavioral health needs must make efforts to seek care in the specialty sector, and often go without care for their disorders. 

Supported by the Mental Health Parity and Addictions Equity Act (MHPAEA) and the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act (ACA), healthcare systems are undergoing rapid reform to develop integrated models of behavioral healthcare and primary care.   Since the enactment of the ACA, more than 11.7 million Americans have gained insurance and may seek primary healthcare for the first time. The newly insured are likely to be living in poverty and may have especially complex behavioral healthcare needs.  As a field, social work recognizes a special duty to ameliorate the conditions of people living in poverty, has a longstanding commitment to care for the whole person, and is grounded in ecological and systems models; these attributes position social work to leverage a unique and influential role in the transition to more fully integrated care. 

The federal government and social work educators have committed substantial resources to developing the behavioral healthcare workforce for integrated care, and to evaluating effects of integrated care.  The development of research infrastructures supporting comparative effectiveness evaluation of models of integrated care is an essential project to which social work can make a unique contribution. 

This workshop presents perspectives of multiple stakeholders in developing sustainable treatment delivery and educational models and building an infrastructure to support comparative effectiveness evaluation of models of integrated care.  Contributors to the workshop include leadership from multiple stakeholder organizations, including insurers, integrated care providers, educators, researchers, and the Substance Abuse and Mental Health Services Administration. 

Presenters will discuss 1) the role of federal resources in developing the behavioral health workforce and evaluating the effectiveness of integrated care, 2) how to collaborate with providers and payers to develop sustainable workforce development models, 3) how to developing a comparative effectiveness evaluation infrastructure based on a shared understanding of models of integrated care, 4) the use of data in informing practice and policy decisions. 

During a three-hour session, presenters will address each of the topics above in prepared statements, followed by brief question and answer sessions.  Following the presentations, participants will meet in small groups to outline plans leading towards the development of comparative effectiveness evaluation infrastructures.  Each presenter will consult directly with one or more small group.  As time permits, one or more groups will share plans to conclude the workshop.