Table 1.

Primary Care Behavioral Health Intervention Components (per Hunter CL & Goodie JL, 2010)

Clinical	Full time on-site primary care behavioral health clinician (1 per 7500 patients23) Clinician availability for personal, face-to-face introductions (“warm handoffs”) and consultation Brief evidence-supported treatment interventions; other clinical care responsibilities Intensive training of primary care behavioral health clinicians, using standardized protocols for a broad range of psychological and medical problems amenable to behavioral health treatment Population (panel) based care using measurement-based, stepped treatment and other resources
Operational	Screening for mental health, substance abuse, and health behavior issues and provider decision support seamlessly integrated into patient flow Reengineering of practice processes, e.g. “warm handoffs”, automated scheduling, referrals, etc. Training providers and staff in behavioral care procedures Appointment frequency and interval of behavioral health clinician consistent with primary care Shared, transparent EHR with two-way notes and access to information Care management coordination of referrals and information with specialty care as needed
Finance	Brief interventions, which are lower cost services, provided over shorter episodes of care Coordination of services and finances to optimize sustainability Negotiation of appropriate reimbursement Regular reports of performance, RVU and financial data