New White Paper: Road Ahead for Primary Care and Behavioral Health

To provide the best possible care to patients and thrive in new payment environments, community health centers (CHCs) and community behavioral health organizations (CBHOs)—two pillars of the safety net—are redesigning their workflows, infrastructure, and partnerships. With support from the Robert Wood Johnson Foundation, the Delta Center for a Thriving Safety Net presents a Model for Advancing High Performance (MAHP) 2.0—a unified set of evidence-based actions and infrastructure necessary for CHCs and CBHOs to both provide high-quality, comprehensive care and succeed in value-based payment arrangements. MAHP 2.0 builds on the original MAHP, which was supported by the California Health Care Foundation and focused on primary care. MAHP 2.0 offers a greater emphasis on behavioral health, and its bidirectional integration into primary care, recognizing the power and importance of both sectors working together to improve people’s health and well-being and to control increasing health care expenditures.

The MAHP 2.0 model provides CHCs and CBHOs with a roadmap to support three interdependent areas of work—improving care to demonstrate value, investing in infrastructure to support improved care, and developing and leveraging partnerships—that are necessary to achieve a financially sustainable safety net that results in the quintuple aim: better whole-person care, better health, lower costs, happier staff, and reduced health disparities.

The MAHP 2.0 highlights that the overall payment and delivery reform goals and efforts of CHCs and CBHOs overlap, as do the infrastructure components that are needed to support these goals and efforts. However, the steps needed to operationalize these approaches and establish supporting infrastructure will often differ between CHCs and CBHOs, as the behavioral health and primary care fields have different funding sources, data reporting requirements, regulatory policies, and partnerships. The MAHP 2.0 gives CHCs and CBHOs a shared framework to understand how their goals overlap, despite differences in organizational culture, clinical language, and processes. By highlighting shared goals, this framework can help guide conversations both within and between primary care and behavioral health organizations that are pursuing improvements in care through value-based payment.

The Delta Center for a Thriving Safety Net is a national initiative led by JSI, the Center for Care Innovations (CCI), and the MacColl Center for Health Care Innovation at Kaiser Permanente Washington Health Research Institute (MacColl) that provides technical assistance to state primary care associations and behavioral health state associations to advance value-based payment and care.