Primary Care—Behavioral Health Integration - Cambridge Health Alliance

Cambridge Health Alliance | Somerville, MA

Cambridge Health Alliance (CHA), an academic community health system serving Cambridge, Somerville and Boston’s metro-north region, has been engaged in primary care-behavioral health integration for the last 30 years. However, nearly four years ago, the organization began implementing a formal system of integration based on the IMPACT (Improving Mood—Promoting Access to Collaborative Treatment) or Collaborative Care model, beginning with a pilot program at one clinic in fiscal year 2014 and then spreading the model throughout the CHA system.

As a result, all 12 of CHA’s primary care centers recently received the Patient-Centered Medical Home PRIME Certification from the Massachusetts Health Policy Commission. Only 25 clinics across Massachusetts have received this certification to date.

CHA’s Primary Care Behavioral Health Integration program includes a system of screening for common behavioral health disorders, a registry to keep track of patients who screen positive, active care management with proactive follow-up, education of primary care providers on behavioral health disorders, and algorithm-driven treatment. The algorithm includes a stepped system of care for behavioral health patients. All primary care patients with behavioral health concerns are categorized into steps 0 through 4 based on the severity and complexity of their needs. To accomplish this work and bolster primary care team members’ skills, CHA added an unlicensed mental health care partner (to perform brief coaching and coordination functions) as well as licensed therapists and psychiatrists into every primary care practice.