Name
At the Crossroads of Mission and Margin: Building a Financially Sustainable Integrated Program
Description

This presentation describes how a large, non‑profit healthcare system transformed its Behavioral Integrated Program—comprising over 50 licensed psychologists embedded in primary care, specialty care, and assessment—from losing millions of dollars annually to achieving financial break‑even. At a time when healthcare is at a crossroads, we outline the strategic, operational, and cultural shifts that aligned integrated psychology with value‑based care while improving access and quality. The session highlights the importance of role clarity, brief population‑based care models, and system‑level leadership in achieving sustainability.

Speakers
Tyson Payne, PsyD
Elisa Rudd, PsyD
Content Level
Intermediate
Tags
Financing and Operational Sustainability, Quality improvement programs, Sustainability
Session Type
Concurrent
Objective 1
Describe system‑level factors that commonly drive financial losses in integrated behavioral health programs.
Objective 2
Identify key redesign strategies that align integrated psychology services with value‑based and population health goals.
Objective 3
Explain how role clarity, visit structure, and scope‑appropriate care can improve both access and financial performance.
Content Reference 1

Koehler AN, Ip E, Davis SW, Hilburn JF, Lord RW Jr, Marion GS, Kirk JK. Cost Analysis of Integrated Behavioral Health in a Large Primary Care Practice. J Clin Psychol Med Settings. 2022 Jun;29(2):446-452. doi: 10.1007/s10880-022-09866-9. Epub 2022 Mar 24. PMID: 35325350.

Content Reference 2

Westfall JM, Jabbarpour Y, Jetty, A, Kuwahara R, Olaisen H, Byun H, Kamerow D, Guerriero M, McGehee T, Carrozza M, Topmiller M, Grandmont J. Rankin J. The State of Integrated Primary Care and Behavioral Health in the United States 2022. Robert Graham Center, HealthLandscape. May 31, 2022. https://www.graham-center.org/home.html | https://healthlandscape.org/

Content Reference 3

Nagykaldi Z, Littenberg B, Bonnell L, Breshears R, Clifton J, Crocker A, Hitt J, Kessler R, Mollis B, Miyamoto RES, van Eeghen C. Econometric evaluation of implementing a behavioral health integration intervention in primary care settings. Transl Behav Med. 2023 Aug 11;13(8):571-580. doi: 10.1093/tbm/ibad013. PMID: 37000706; PMCID: PMC10415735.

Content Reference 4

Anvari-Clark J. Financial Health is Behavioral Health: Enhancing Integrated Care Practice. J Evid Based Soc Work (2019). 2025 Aug 7:1-28. doi: 10.1080/26408066.2025.2542448. Epub ahead of print. PMID: 40773538.

Content Reference 5

Page, C., Mauri, A., Grazier, K., Buche, J., & Gaiser, M. (2023). Financing behavioral health integration and collaborative care models (Policy brief). University of Michigan Behavioral Health Workforce Research Center.
https://www.healthworkforceta.org/wp-content/uploads/2023/07/BHWRC_Financing-Behavioral-Health-Integration_Policy-Brief.pdf