The AHRQ Academy for Integrating Behavioral Health and Primary Care’s recent webinar, From Coding to Braiding: Strategies for Financing and Sustaining Integrated Behavioral Health in Primary Care Settings, explored how practices can move beyond a narrow focus on billing codes and toward a broader, more sustainable financing strategy that supports whole-person care.

During the session, presenters Monique Thornton, MPH; Jodi Polaha, PhD; and Judith Steinberg, MD, shared practical strategies for financing IBH, including how organizations can braid multiple funding streams, build a stronger business case for integration, and plan for long-term sustainability. The presenters also introduced the Integration Academy’s newly launched Integrated Behavioral Health Financing Toolkit, a resource designed to help health care leaders, providers, and practice staff move from financing concepts to actionable plans. The Toolkit is organized around three core activities:

• Planning an IBH funding mix;
• Calculating costs, savings, and revenue; and
• Tailoring financing strategies to different practice settings, payer mixes, and patient populations.

Moving Beyond the Search for the “Right” Billing Code

One of the webinar’s clearest messages was that there is no single billing code or funding source that can sustain IBH on its own.

While reimbursement remains important, traditional fee-for-service reimbursement rarely covers the full cost of integrated behavioral health. This is why presenters framed the discussion around braiding rather than coding. Successful organizations increasingly combine multiple sources of funding, including fee-for-service payments, value-based payment arrangements, grants, philanthropy, graduate medical education funding, and internal cross-subsidization.

The goal is not to find one perfect revenue stream, but rather to build a diversified financing mix that can support integrated care over time.

Rethinking How We Measure Financial Success

The webinar also challenged attendees to rethink how they evaluate the financial success of integrated care.

Rather than viewing behavioral health integration as a standalone service line that must generate enough revenue to cover its own costs, speakers encouraged participants to view IBH as an investment that creates value across an organization.

That value may show up through improved management of chronic conditions, reduced provider burden, increased access to care, and lower overall healthcare costs. These benefits may not be fully reflected in traditional billing reports, but they are central to understanding the financial and operational value of IBH.

A recurring theme throughout the discussion was the need to shift from asking, “Does IBH break even?” to “What value does IBH create?”

A Real-World Example of Braided Financing in Action

The webinar’s centerpiece was an applied case study, showing how a fictional rural health clinic could use the Toolkit to plan financing for a behavioral health consultant focused on opioid use disorder and suicide risk.

Presenters demonstrated how the Toolkit can be leveraged to identify funding opportunities, estimate start-up costs, model revenue and savings, and build a phased financing strategy that evolves over time. The example showed how grants and other supplemental funding sources can help launch a program, while optimized reimbursement and value-based payment arrangements can support long-term sustainability.

The case study helped translate braided financing from an abstract concept into a practical roadmap that organizations can adapt to their own contexts.

Building the Business Case for IBH

Speakers also highlighted the toolkit’s customizable IBH Pro Forma Calculator, which allows practices to estimate staffing needs, project costs and revenue, model different payer mixes, and quantify potential savings.

Importantly, presenters emphasized that building a business case for IBH requires more than documenting reimbursement. Organizations should also consider factors like improved patient outcomes, reduced provider burden, operational efficiencies, and downstream cost savings when demonstrating the value of integrated care.

This broader view can help leaders make the case that IBH is not just another service to fund. It is an investment in better access, stronger primary care teams, and more sustainable whole-person care.

Looking Ahead

The discussion concluded with a look at emerging opportunities to support integrated care, including Medicare’s Advanced Primary Care Management (APCM) and Behavioral Health Integration add-on codes, which may provide new pathways for supporting comprehensive primary care and behavioral health services.

For organizations working to launch, expand, or sustain integrated behavioral health programs, the webinar offered a clear takeaway: sustainable financing is not a coding exercise alone – it is a planning process, a business case, and a long-term investment in whole-person care.

The webinar recording is available to view here, and the AHRQ Integration Academy’s Integrated Behavioral Health Financing Toolkit is available here.

Photo by Jakub Żerdzicki on Unsplash