BHI Compendium

The BHI Compendium serves as a tool to learn about behavioral health integration (BHI) and how to make it effective for your practice and patients. The aim is to provide accessible, detailed information on the steps required to integrate behavioral health into your practice along with direct links to resources for more specific information.

AMA welcomes shared stories about implementing behavioral health, and asks for input on what information should be featured in future iterations of the Compendium by emailing Practice.Sustainabi[email protected].

This collection provides a high-level overview of each part of the Compendium and its chapters, along with a download of the full Compendium.

—Part 1: Compendium basics

—Part 2: BHI basics and background

—Part 3: Getting started

—Part 4: Implementation

Overcoming Obstacles webinar series

Learn how the various aspects covered in the BHI Compendium can work in real-world practice settings with the BHI Collaborative’s webinar series "Overcoming Obstacles". This series enables physicians to incorporate behavioral health care into their practices during COVID-19 and beyond.

Part 1: Welcome to the Behavioral Health Integration Compendium

Chapter 1: Compendium basics

Explore the basics of the BHI Compendium, which condenses an abundance of carefully vetted, existing quality BHI resources and is meant to provide helpful frameworks and actionable information for effective BHI in your practice.

A note about using the BHI Compendium

Different pathways may be pursued to integrate behavioral health into primary care, pediatrics, obstetrics and gynecology or other specialty care. The goal of this resource is to meet practices wherever you are on your integration journey..

It is also important to recognize that integration is a continuous process and not a time-limited project. There are many ways to pursue BHI and endless opportunities to modify such efforts as patient needs and practice resources evolve. 

Share your stories

The Collaborative encourages you to share additional resources you’ve found valuable for implementing behavioral health in your practice and asks for input on how to potentially improve the Compendium for future iterations. 

Part 2: BHI Basics and Background

Chapter 2: BHI definitions 

Learn why BHI is important and its many benefits in Chapter 2, including key definitions:

What is behavioral health (BH)?

For this Compendium, behavioral health (BH) refers to care that addresses mental health and substance use disorders, life stressors and crises, and stress-related physical symptoms. 

What is behavioral health integration (BHI)?  

BHI is widely accepted as the result of primary care (or other care settings) and behavioral health clinicians, working together with patients and families, using a systematic approach to provide patient-centered care.

Chapter 3: Introduction to Various Models of Care

This chapter includes the basic elements of the most common models of care, which can be implemented as is, or in a combination most appropriate for a specific practice.

Explore the different models of care and selection criteria for level of integration, to choose what’s right for your practice.

Resources

—The Six Levels of Collaboration/Integration: The six levels of collaboration/integration are organized by Coordinated, Co-Located, and Integrated in this table. The core description, key differentiators, strengths and weaknesses of each level are explained.

—Collaborative Care Model (CoCM) Information and Details: Find further information and detail on the CoCM, including free training.

Part 3: Getting Started

Chapter 4: Making the Case: Establishing the Value of BHI 

This chapter outlines the various benefits of integration and explores how to present the benefits of integration for various stakeholders, particularly how implementing BHI is a worthwhile investment in the long-term for practices.

Resources

—Comparing Payment Models for RHCs and FQHCs: Compare the CoCM, BHI, and psychiatric CoCM in terms of requirements and payment for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).

Chapter 5: Assessing Readiness

Once you have made the case for integration, this chapter explores why it's important to consider long and short-term goals within the organization and key tips for assessing readiness in the process of implementing BHI.

Resources

—Organizational Assessment Toolkit for Primary and Behavioral Health Care Integration: Two Major Self-Assessment Tools: Access this PDF to utilize two major self-assessment tools: the Partnership Checklist and the Executive Walkthrough.

—Mental Health Practice Readiness Inventory: Access this PDF to determine level of readiness and identify areas where your practice may need to focus efforts. 

Chapter 6: Establishing Metrics of Success

Find the next best steps for your organization, partners and programs in Chapter 6. Integration of behavioral health can begin (or continue) by finding the best next step that your organization, its partners, and each of its programs can and will take. Keep in mind that any action towards integration, no matter how small, can have significant impact.

Resources

—Organizational Assessment Toolkit for Primary and Behavioral Health Care Integration: Two Major Benchmarking Tools: Access this PDF to utilize two major benchmarking tools: the Administrative Readiness Tool (ART) for Primary Health Behavioral Health Integration, and the COMPASS-Primary Health and Behavioral Health.

Chapter 7: Aligning the Team

See how important everyone on the team is to effective integration and the potential responsibilities each care team member may have. In a physician-led team-based behavioral health model of care, the entire team works together to provide collaborative care to patients.

Resources

—Identifying National Resources: This link contains additional resources and helplines available to physicians and patients. 

—Identifying Local Resources: Through AuntBertha.com, information regarding locating and accessing local behavioral health resources is provided by entering only a zip code or location.

Part 4: Implementation

Chapter 8: Designing the Workflow

Focus on how to create processes and protocols for the entire care team to recognize when the behavioral health specialist should become involved.

Resources

—Team Building & Workflow Guide: This document can be used to help guide you through the workflow and align on a plan.

Chapter 9: Preparing the Clinical Team

Understand the steps for preparing the care team in Chapter 9. Help achieve the success metrics for your practice by ensuring everyone knows their individual role and responsibilities.

Resources

—The Partnership Checklist: Utilize this Partnership Checklist to determine if a partnership is necessary to achieve the desired outcomes for the integration program in your practice or organization.

—Integration Training Resources: For direct training manuals on integration and important steps along the way, utilize the manuals provided from UPenn's Center for Studies on Addiction.

Chapter 10: Partnering with the Patient

It is important that care teams explain the “why and how” of integrated care to patients. This chapter explores best practices to engage and activate patients in their care.

Resources

—Implementing Mental Health Priorities in Practice: Strategies to Engage Patients and Families: This resource consists of videos demonstrating examples of patient/family encounters that encompass the most difficult conversation areas for various mental health topics.

—Mnemonic for Communication Best Practices (PDF): This document contains helpful considerations for communication methods when working with patients.

Chapter 11: Financial Sustainability: Billing & Coding

There is no "one-size-fits-all” financial model for BHI. Explore different approaches to finance your BHI activities in this chapter.

Resources

—Financial Modeling Workbook: For more information regarding financial modeling, see this website for access to a free resource.

—Codes for Services Under Medicaid (PDF): Find details on services, codes and rates for community and private mental health centers.

Chapter 12: Measuring Progress

As integration is a process that is constantly evolving, it is important that you continue to check your progress and reassess where you need to grow along the way.

Resources

—Using Benchmarking to Drive Successful Integration: Watch this CIHS and SAMHSA-HRSA Webinar on the use of benchmarking for information on how benchmarking can drive successful behavioral and primary care integration.