Name
B2 - From Coding to Braiding: Strategies for Financing and Sustaining Integrated Behavioral Health in Primary Care Settings
Speakers
Danielle Durant, Westat
Jodi Polaha, ETSU
Judith Steinberg, Harvard Medical School Center for Primary Care
Monique Thornton, Let’s Talk Public Health
Co-Authors
Danielle Durant, PhD, MS, MS, MBA, Principal Research Associate, Westat, Bethesda, MD
Date & Time
Wednesday, May 6, 2026, 1:45 PM - 2:45 PM
Description

How do you bridge the gap between the need for providing integrated behavioral health services and the persistent challenge of financing and sustainability? This session introduces the Financing and Sustaining Integrated Behavioral Health in Primary Care Settings Toolkit, developed by the Agency for Healthcare Research and Quality (AHRQ) Academy for Integrating Behavioral Health and Primary Care. The presenters will discuss the shared mental models necessary for promoting financial sustainability for behavioral health integration, potential funding sources, and foundational financing strategies. The session will conclude with an applied scenario demonstration, where presenters walk through using the toolkit to estimate costs, savings, and revenue and tailor financing strategies for a specific payer mix, primary care setting, and patient population.

Abstract
Most primary care settings rely primarily on fee-for-service payments for behavioral health integration; however, traditional reimbursement often fails to account for its costs (Ma et al., 2022; Schmerling et al., 2020). Establishing a financially sustainable integrated behavioral health model can require transitioning from fee-for-service to alternative payment models and braiding together multiple funding sources. This session is designed for healthcare executives, finance directors, practice managers, clinicians, and other providers seeking practical solutions for long-term operational and financial sustainability. The session will introduce the AHRQ Academy Financing and Sustaining Integrated Behavioral Health in Primary Care Settings Toolkit and review key mental models, funding sources, and foundational financing strategies.

Attendees will learn how to use the toolkit’s strategies, tools, and resources to estimate costs, savings, and revenue for behavioral health integration and tailor a financing plan to their specific payer mix, setting, and patient population.
Session Type
Concurrent
Objective 1
Identify the diverse funding streams available for behavioral health integration.
Objective 2
Apply financial modeling tools to generate cost, savings, and revenue estimates for an integrated behavioral health program.
Objective 3
Describe foundational integrated behavioral health financing strategies that cross-cut payer mix, setting, and patient population to ensure long-term operational sustainability.
Content Reference 1

Shmerling AC, Gold SB, Gilchrist EC, Miller BF. Integrating behavioral health and primary care: a qualitative analysis of financial barriers and solutions. Transl Behav Med. 2020 Aug 7;10(3):648–56.

Content Reference 2

Ma KPK, Mollis BL, Rolfes J, Au M, Crocker A, Scholle SH, et al. Payment strategies for behavioral health integration in hospital-affiliated and non-hospital-affiliated primary care practices. Transl Behav Med. 2022 July 26;12(8):878–83.

Content Reference 3

Marcotte LM, Reddy A, Zhou L, Razliff A, Unützer J, Chang D, et al. Provision of Collaborative Care Model and General Behavioral Health Integration Services in Medicare. Psychiatr Serv. 2021 July;72(7):822–5.

Content Reference 4

Cross DA, Qin X, Huckfeldt P, Jarosek S, Parsons H, Golberstein E. Use of Medicare’s Behavioral Health Integration Service Codes in the First Two Years: an Observational Study. J Gen Intern Med. 2020 Dec;35(12):3745–6.

Content Reference 5

Lombardi BM, Greeno C, de Saxe Zerden L. Examining the use of psychiatric collaborative care and behavioral health integration codes at federally qualified health centers: A mixed-methods study. Fam Syst Health. 2023;41(4):527–36.