Facilitators of and barriers to County Behavioral Health System Transformation and Innovation: an interview study.
Behavioral health
Digital resource navigation
Payor-agnostic care
System transformation
Value-based payment
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
09 May 2024
09 May 2024
Historique:
received:
08
02
2024
accepted:
24
04
2024
medline:
9
5
2024
pubmed:
9
5
2024
entrez:
9
5
2024
Statut:
epublish
Résumé
Inadequate and inequitable access to quality behavioral health services and high costs within the mental health systems are long-standing problems. System-level (e.g., fee-for-service payment model, lack of a universal payor) and individual factors (e.g., lack of knowledge of existing resources) contribute to difficulties in accessing resources and services. Patients are underserved in County behavioral health systems in the United States. Orange County's (California) Behavioral Health System Transformation project sought to improve access by addressing two parts of their system: developing a template for value-based contracts that promote payor-agnostic care (Part 1); developing a digital platform to support resource navigation (Part 2). Our aim was to evaluate facilitators of and barriers to each of these system changes. We collected interview data from County or health care agency leaders, contracted partners, and community stakeholders. Themes were informed by the Consolidated Framework for Implementation Research. Five themes were identified related to behavioral health system transformation, including 1) aligning goals and values, 2) addressing fit, 3) fostering engagement and partnership, 4) being aware of implementation contexts, and 5) promoting communication. A lack of fit into incentive structures and changing state guidelines and priorities were barriers to contract development. Involving diverse communities to inform design and content facilitated the process of developing digital tools. The study highlights the multifaceted factors that help facilitate or hinder behavioral health system transformation, such as the need for addressing systematic and process behaviors, leveraging the knowledge of leadership and community stakeholders, fostering collaboration, and adapting to implementation contexts.
Sections du résumé
BACKGROUND
BACKGROUND
Inadequate and inequitable access to quality behavioral health services and high costs within the mental health systems are long-standing problems. System-level (e.g., fee-for-service payment model, lack of a universal payor) and individual factors (e.g., lack of knowledge of existing resources) contribute to difficulties in accessing resources and services. Patients are underserved in County behavioral health systems in the United States. Orange County's (California) Behavioral Health System Transformation project sought to improve access by addressing two parts of their system: developing a template for value-based contracts that promote payor-agnostic care (Part 1); developing a digital platform to support resource navigation (Part 2). Our aim was to evaluate facilitators of and barriers to each of these system changes.
METHODS
METHODS
We collected interview data from County or health care agency leaders, contracted partners, and community stakeholders. Themes were informed by the Consolidated Framework for Implementation Research.
RESULTS
RESULTS
Five themes were identified related to behavioral health system transformation, including 1) aligning goals and values, 2) addressing fit, 3) fostering engagement and partnership, 4) being aware of implementation contexts, and 5) promoting communication. A lack of fit into incentive structures and changing state guidelines and priorities were barriers to contract development. Involving diverse communities to inform design and content facilitated the process of developing digital tools.
CONCLUSIONS
CONCLUSIONS
The study highlights the multifaceted factors that help facilitate or hinder behavioral health system transformation, such as the need for addressing systematic and process behaviors, leveraging the knowledge of leadership and community stakeholders, fostering collaboration, and adapting to implementation contexts.
Identifiants
pubmed: 38720309
doi: 10.1186/s12913-024-11041-9
pii: 10.1186/s12913-024-11041-9
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
604Subventions
Organisme : Orange County Health Care Agency
ID : MA-042-21011324
Organisme : Orange County Health Care Agency
ID : MA-042-21011324
Organisme : Orange County Health Care Agency
ID : MA-042-21011324
Organisme : Orange County Health Care Agency
ID : MA-042-21011324
Organisme : Orange County Health Care Agency
ID : MA-042-21011324
Organisme : Orange County Health Care Agency
ID : MA-042-21011324
Organisme : Orange County Health Care Agency
ID : MA-042-21011324
Organisme : Orange County Health Care Agency
ID : MA-042-21011324
Organisme : Institute for Clinical and Translational Sciences
ID : UL1TR001414
Organisme : Institute for Clinical and Translational Sciences
ID : UL1TR001414
Organisme : Institute for Clinical and Translational Sciences
ID : UL1TR001414
Informations de copyright
© 2024. The Author(s).
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