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Primary and Behavioral Health Care Integration Program: Impacts on Health Care Utilization, Cost, and Quality

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This report describes an extension of the RAND Corporation's evaluation of the Substance Abuse and Mental Health Services Administration's Primary and Behavioral Health Care Integration (PBHCI) grants program. PBHCI grants are designed to improve the overall wellness and physical health (PH) status of people with serious mental illness (SMI) or co-occurring substance use disorders by supporting the integration of primary care and preventive PH services into community behavioral health (BH) centers where individuals already receive care. From 2010 to 2013, RAND conducted a program evaluation of PBHCI, describing the structure, process, and outcomes for the first three cohorts of grantee programs (awarded in 2009 and 2010). That evaluation found wide variation in program structures, a range of implementation barriers, and some consumer-level improvements in PH outcomes (e.g., cholesterol, diabetes management). The current study extends previous work by investigating the impact of PBHCI on consumers' health care utilization, total costs of care to Medicaid, and quality of care in three states.

This report was prepared under contracts #HHSP23320095649WC and #HHSP23337015T between HHS's ASPE/DALTCP and the RAND Corporation. For additional information about this subject, you can visit the DALTCP home page at or contact the ASPE Project Officer, Joel Dubenitz, at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201;

DISCLAIMER: The opinions and views expressed in this report are those of the authors. They do not reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. This report was completed and submitted on October 2016.