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, […]
I’ll keep this short, because I know you’re tired. I know because I’m watching it in real time. At CFHA – The Integrated Care Association, workgroups that used to convene monthly have scaled back, not because the work is done, but because people are tapped out. In my clinic, residents who would have once jumped […]
The game is played back and forth, each side jostling to score a goal where possible. The scoring can be few and far between, a lot more chances and shots at goals, than reward. Often the activity is quick, a quick run by a team toward the goal, and then the ball is going backward the other way, exchanging possession back and forth… Yet […]
As is often the case with scientific breakthroughs, Lister was not satisfied with prevailing explanations for high post-surgical mortality. Instead, he looked elsewhere, guided by observation. In hindsight, it is striking how long established—yet incorrect—explanations persisted. These were not only scientific but cognitive: reinforced by shared assumptions that made alternative interpretations difficult to see. In […]
“Today, we take clear and decisive action to confront our nation’s mental health crisis by addressing the overuse of psychiatric medications—especially among children,” said Secretary Kennedy. “We will support patient autonomy, require informed consent and shared decision-making, and shift the standard of care toward prevention, transparency, and a more holistic approach to mental health.” In […]
That gap, between what the chart said, and what I read in the room, is where much of the work happens in primary care. Universal screening with validated tools, brief intervention, referral to treatment (e.g., SBIRT) has a robust evidence base, and at the population level, it works. A well-resourced implementation trial across 22 primary […]
Table 1 Documentation Guidelines for Clinical Notes (Adapted from Reiter, 2023) Do Avoid Be brief and concise. Avoid using names outside of the patient’s name. Keep quotes to a minimum. Avoid terms like seems, appears. Use an active voice. Avoid value-laden language, common labels, opinionated statements. Use precise and descriptive terms. Do not use terminology […]
There was nothing particularly remarkable about that day. It wasn’t sunny. It didn’t rain. The clouds offered no movement, no promises of new shapes with hidden messages. It was just a gray day, like so many others. And yet, it became a day I would remember. It all started with a call about a patient […]
There is a copy of a Thich Nhat Hanh book in her exam room. I imagine it as an amulet, or maybe a mantra, quietly working on her behalf: “I am a continuation, like the rain is a continuation of the cloud.” She cannot be anything less, anything more. In fifteen minutes, she is expected to earn […]
A new Pediatric Collaborative Pathway has been developed to solve this problem, offering a structured, feedback-driven system that turns chaos into clarity. Here are four practical ways to implement this pathway in your practice today. 1. Make Screening Meaningful Screening shouldn’t just be a compliance task; it is the foundation of clinical decision-making. The pathway […]
Collaborative documentation is far more than a technique for writing notes. When used intentionally, it becomes a foundation for partnership‑based care and serves multiple meaningful functions that shape the clinical encounter itself. The Functions of Collaborative Documentation A Process and an Outcome Collaborative documentation turns the note into both a shared activity and a tangible […]
For these practices, an Integrated Psychiatry approach—directly informed by the Primary Care Behavioral Health (PCBH) model—provides a flexible, population‑focused alternative. PCBH emphasizes rapid access, same‑day consultation, brief interventions, and team‑based care embedded directly within primary care workflows. Applying these principles, Integrated Psychiatry brings psychiatric expertise into the pediatric medical home, enhancing access, reducing stigma, strengthening […]
Over time, I’ve noticed more PCBH job postings recruit only for LISW/LPCC/LMFT (or equivalent). From my experience, many psychologists would love to work in PCBH, but they never get the chance. Many job postings don’t even list psychologists as an option, and when contacted, organizations often can’t offer pay that fits the level of training […]
Our book has six parts. The first is an update on the evidence for making this huge change to the scope and delivery of primary care services. We speak directly to leaders, with a hope of preparing them for a successful launch and scale-up. In the second and third sections, we provide information on specific […]
Marcus is a 40‑year‑old African American man whose primary care provider (PCP) recently noted significant changes in mood following his ALS diagnosis two months ago. During several follow‑up appointments, the PCP observed that Marcus appeared less engaged, showed diminished interest in life, and expressed overwhelming concern about what the progression of the disease might mean […]
Disclaimer: This blog was originally published on the National Academy for State Health Policy (NASHP) website (nashp.org) on 11.18.25. It is reproduced here with the permission of the author. You can access the original blog post at this link: How States Are Modernizing Facility Licensure to Advance Integrated Care – NASHP Modernizing facility licensure is […]
Our national example has been Prospect Medical Holdings, a for-profit, 17-hospital chain serving mostly low-income patients in California, Pennsylvania, Connecticut, Rhode Island, and New Jersey. As early as 2020, ProPublica, the independent investigative journalism outfit, published a lengthy expose about how Leonard Green and Partners, a Los Angeles-based private equity firm which bought a controlling […]
How Micro-Skills Shape Patient Outcomes and Interprofessional Collaboration through fostering an integrated care model that brings together medical, behavioral, and allied health professionals to provide comprehensive, whole-person treatment. Through this post we will dive into the argument that communication functions as a core clinical and operational competency in not only integrated care, but effective care. […]
