A high-performance framework to integrate primary care and behavioural health
Abstract
This paper describes a large statewide initiative in Arizona led by the Arizona Medicaid programme to integrate the delivery of primary care and behavioural services. Healthcare in the USA remains fragmented, as reflected in no small measure by the separation of primary care and mental health services, in both structure and delivery. The fact that this historical separation continues to be perpetuated is detrimental to the goals of the Triple Aim. The fragmentation between both clinical service lines is further compounded by the high rate of co-occurring physical and mental illness, shortage of mental health professionals, under-skilling of primary care providers in the management of mental health, and stigma associated with mental illness. Underserved communities, where trust deficits of healthcare systems are commonplace, are especially vulnerable to the untoward effects of fragmented services. In this paper a framework is described to integrate primary care and behavioural health, implemented as a multi-year, multi-stakeholder programme at microsystem level, with policy implications for improving access, outcomes, costs and disparities.
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Author's Biography
Roshini Moodley Naidoo , MBChB, MPH, MBA, is Professor of Practice in the College of Health Solutions at Arizona State University and Senior Fellow at the Mossavar-Rahmani Center for Business and Government at the Harvard Kennedy School. She is a global Healthcare Executive and experienced practitioner, with expertise in leading transformative initiatives at scale in value-based contracting, risk management, population health management, healthcare digitisation and patient-reported outcome measures (PROMs). Naidoo served as a Fellow with the Leapfrog Group, the global specialist in patient safety and quality improvement, where her work involved hospital quality ratings and healthcare equity best practices. She is a physician who has a master’s in public health from Harvard T.H. Chan School of Public Health and a master’s in business administration from Harvard Business School.
Kailey Love , MBA, MS, is Senior Project Manager in the College of Health Solutions at Arizona State University. She has a decade of experience in managing large health-related research projects. She has a master’s in business administration from the Eller College of Management, University of Arizona, and a master’s in science of healthcare delivery from Arizona State University.
George Runger , PhD, is Professor in the School of Computing and Augmented Intelligence at Arizona State University. He researches analytical methods for knowledge generation and data-driven improvements in organisations. He focuses on machine learning for large, complex data and real-time analysis, with applications to surveillance, decision support and population health. Previously, he was a senior engineer and technical leader for data analytics projects at IBM. Runger holds degrees in industrial engineering and statistics. He was the inaugural department editor for healthcare informatics for ISIE Transactions on Healthcare Systems Engineering.
Cameron Adams , MPP, is the lead of the Arizona Health Care Cost Containment System (AHCCCS) Health Equity Data Subcommittee and Administrator of Targeted Investments (TI) Programs. He earned a master’s in public policy through ASU College of Public Service and Community Solutions, completed the ASU CONHI Health Policy Academy (twice) and graduated from the AHCCCS Leadership Academy during his past decade at AHCCCS. He has prior experience in Arizona Long Term Care (ALTCS) system eligibility, training, policy, budget and, prior to administering the programme, as the data coordinator for the TI 1.0 Program.
Michael Franczak , PhD, currently serves as Director of Population Health Services for Copa Health, Phoenix, Arizona. He has been involved in Mental Health, Substance Abuse and Development Disability services in Pennsylvania, North Carolina and Arizona for the past 40 years. Franczak has served as an expert witness in many landmark cases concerning mental health and developmental disabilities and serves as an expert to the US Department of Justice Civil Rights Division. He has been the primary investigator on numerous grants from the Substance Abuse Mental Health Service administration, including Housing Approaches for Persons with a Serious Mental Illness, Jail Diversion for Persons with a Serious Mental Illness, Integrated Substance Abuse Mental Health Treatment Models System of Care Practices for Children and Adolescents and Substance Abuse Services for Adolescents.
William Riley , PhD, is Professor for the College of Health Solutions at Arizona State University and Director of the National Safety Net Advancement Center, which assists safety organisations in responding to healthcare payment reform. His area of expertise is value-based payment, healthcare finance and population health improvement. He has led numerous projects to improve population health metrics at the regional, national and international levels. He leads translational research projects in international settings, oral health value-based care and multisector alignment to achieve a culture of health. Riley has over 20 years’ executive experience as a former president and chief executive officer of several healthcare organisations, including a Blue Cross Blue Shield of Minnesota subsidiary, a large multispecialty medical group, and an integrated delivery system serving disadvantaged populations. Prior to joining ASU, he was the associate dean for the School of Public Health at the University of Minnesota.
Citation
Moodley Naidoo, Roshini, Love, Kailey, Runger, George, Adams, Cameron, Franczak, Michael and Riley, William (2024, September 1). A high-performance framework to integrate primary care and behavioural health. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 9, Issue 1. https://doi.org/10.69554/PVLG1987.
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