Health care reform and care at the behavioral health--primary care interface.

The historic passage of the Patient Protection and Affordable Care Act in March 2010 offers the potential to address long-standing deficits in quality and integration of services at the interface between behavioral health and primary care. Many of the efforts to reform the care delivery system will come in the form of demonstration projects, which, if successful, will become models for the broader health system. This article reviews two of the programs that might have a particular impact on care on the two sides of that interface: Medicaid and Medicare patient-centered medical home demonstration projects and expansion of a Substance Abuse and Mental Health Services Administration program that colocates primary care services in community mental health settings.

Mind and body reunited: improving care at the behavioral and primary healthcare interface.

This paper reviews current models, research, and approaches to improving care on the primary care/behavioral health interface in the USA. We focus on care in the public sector where high rates of comorbidity, regulatory burdens, and lack of resources create particular challenges to collaboration and coordination. To achieve the goals of improved coordination and collaboration, it will be critical to address key financing, workforce, information technology, performance assessment, and research issues.

Application of quality measurement and performance standards to public health systems: Washington State's approach.

To date, there have been few points of intersection between the quality work done in the general health system and performance review in the public health system. This article describes Washington State's set of performance standards for public health, the accreditation-type evaluation process, and some of the results of the recent performance evaluation against the Washington State Standards. Taking action on the evaluation results could enhance the capacity of public health to join general health systems in Washington State to address several of the priority areas described in Transforming Health Care Quality, the 2003 Institute of Medicine Report.