Integrated care—the integration of primary care and behavioral health—is becoming more and more of a prominent topic in the healthcare industry, as this holistic approach to care can improve patients’ health as well as provide financial benefits for healthcare organizations. However, perceptions on how to implement integrated care vary widely—some organizations view it as simple strategies like referring patients, while others believe it involves treating both physical and behavioral health within the same practice. These varied perceptions can make it challenging for healthcare organizations to know how to approach integrated care and for HIT vendors to know how to support customers in these endeavors.
Due to the high interest in integrated care, KLAS sought to capture the current landscape of integrated care. While there is no single solution for integrated care, our recently published report examines how many healthcare organizations have implemented or are implementing integrated care, how they are approaching it, and who they are consulting to achieve it.
What Is Integrated Care & Why Invest in It?
As mentioned before, the definition of integrated care varies widely. This is partly because healthcare organizations have different philosophies and methods for conducting services. In particular, behavioral health organizations often view themselves as unique entities, furthering the differentiation within the market. Inconsistent reporting requirements across US states also make it hard for organizations and vendors to work toward the same goals. Going forward, integrated care will likely continue to be a very fragmented concept. However, federal intervention will provide clearer directions and requirements for organizations to follow (as it has with federally qualified health centers and certified community behavioral health centers), making the process of achieving integrated care more straightforward.
There are significant motivations for behavioral health organizations to pursue integrated care. One is that it supports whole-patient care. Social determinants of health—such as housing instability and food insecurity—can lead individuals to neglect their physical and mental health, and in such situations, integrated care can help organizations provide comprehensive services that address all of a patient’s needs. Additionally, behavioral health organizations receive financial incentives for adopting integrated care; those who meet specific requirements for government reporting can obtain increased reimbursem*nt rates.
Based on KLAS’ findings in the recent report, around 75% of interviewed organizations are employing or plan to employ strategies for integrated care. Among these organizations, many are not approaching integrated care via fully integrating patient information and facilitating seamless data sharing between primary care and behavioral health systems. Instead, they are using smaller strategies that can support integrated care with existing resources and technology. While these strategies can be effective, they do not provide a foundation for integrated care that treats the whole patient.
What Challenges Hinder Integrated Care?
Despite the benefits of integrated care, almost a quarter of the organizations interviewed for KLAS’ report either aren’t planning to do integrated care or are unsure of their plans. Several factors can deter organizations from pursuing integrated care. Firstly, integrated care relies on the ability to share patient data, which generally remains suboptimal. The stringent regulations for sharing behavioral health data also make organizations reluctant to do so (even within their own facility) in order to avoid penalties for potential noncompliance. Until issues with data sharing are addressed, it will continue to be a barrier to true integrated care.
Another challenge lies with the payment structures for healthcare services. If a patient sees their primary care vendor and is referred to a behavioral health provider, that provider may not be covered by the patient’s health plan, which creates another barrier to integrated care and the patient accessing needed services.
Which Technologies Can Help?
Behavioral health organizations considering integrated care don’t always look to HIT vendors, but there are many types of technologies that can help them achieve their goals. Based on feedback from report respondents, EHRs—both multispecialty and behavioral health–specific—are most commonly considered or deployed. In particular, vendors like athenahealth, Epic, and NextGen Healthcare are frequently considered, as multispecialty practices leveraging these EHRs can easily incorporate behavioral health features. This gives these vendors a competitive advantage over behavioral health–specific vendors, who—while able to meet behavioral health needs—are often behind the technology curve for primary care.
Due to the significant need for data sharing, networks and technologies that support it will be paramount for organizations looking to implement integrated care. The infrastructure for data sharing has not always been fully developed, but entities like HIEs and the Trusted Exchange Framework and Common Agreement (TEFCA) have improved data sharing capabilities, making needed data more available to point-of-care clinicians. Over the next few years, there will continue to be advancements in this area.
As there are numerous approaches to integrated care, behavioral health organizations don’t need to feel confined to a single model or type of technology. For example, Azara Healthcare provides a population health platform that can help organizations manage government reporting, providing a straightforward way to secure funding and achieve a quick ROI. Organizations looking to implement integrated care should consider their individual needs and which technologies will best meet those needs.
What’s Next?
KLAS is currently limited in how we monitor integrated care and behavioral health. Historically, we have focused generally on behavioral health, but there are many subcategories of behavioral health to explore, such as outpatient services, specialties (e.g., substance use), and social work. Behavioral health is an underserved market, and we recognize the need for more comprehensive insights. We will continue to refine how we monitor this space and anticipate conducting more extensive research in the future.
To provide valuable insights that will drive the market forward, KLAS needs continued feedback from healthcare organizations. If you work with a vendor who supports integrated care that we do not currently measure, we encourage you to share feedback through our website. Additionally, we would love to hear about any unique strategies that have helped organizations achieve integrated care. Direct feedback from healthcare organizations is invaluable to KLAS as we seek to serve providers and patients.
For more information on integrated care and the technologies supporting it, we encourage all to read our 2024 Integrated Care report.
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