title: Primary care, behavioral health, provider colocation, and rurality.
abstract: OBJECTIVE
  The purpose of this study was to characterize the proximity of primary care and behavioral health service delivery sites in the United States and factors influencing their colocation.
  
  
  METHODS
  We geocoded the practice addresses of primary care and behavioral health providers found in the Centers for Medicare & Medicaid Services' National Plan and Provider Enumeration System Downloadable File to report where colocation is occurring throughout the country.
  
  
  RESULTS
  The extent to which primary care physicians are colocated with behavioral health providers is strongly associated with rurality. Specifically, 40.2% of primary care physicians in urban areas are colocated with behavioral health providers compared with 22.8% in isolated rural areas and 26.5% in frontier areas. However, when controlling for number of primary care physicians at a location, the odds of colocation actually are greater for physicians in a frontier area than those in urban areas (odds ratio, 1.289; P < .01).
  
  
  CONCLUSIONS
  Our findings offer new insights into the overlap of the behavioral health and primary care workforce, where opportunities for integration may be limited because of practice size and the proximity of providers, and where new possibilities for integration exist.
authors.affiliation: the Department of Family Medicine, University of Colorado Denver School of Medicine, Aurora; and The Robert Graham Center, Washington, DC.
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Miller
authors.forename: Stephen
authors.initials: S
authors.lastname: Petterson
authors.forename: Shandra M
authors.initials: SM
authors.lastname: Brown Levey
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Payne-Murphy
authors.forename: Miranda
authors.initials: M
authors.lastname: Moore
authors.forename: Andrew
authors.initials: A
authors.lastname: Bazemore
mesh_terms: D001524:Behavioral Medicine / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D011320:Primary Health Care / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000706:statistics & numerical data; D012424:Rural Population; D000078329:Workforce
keywords: Health Policy; Integrated Delivery Systems; Mental Health; Primary Health Care