title: REACH of Interventions Integrating Primary Care and Behavioral Health.
abstract: OBJECTIVE
  This study reports REACH (the extent to which an intervention or program was delivered to the identified target population) of interventions integrating primary care and behavioral health implemented by real-world practices.
  
  
  METHODS
  Eleven practices implementing integrated care interventions provided data to calculate REACH as follows: 1) Screening REACH defined as proportion of target patients assessed for integrated care, and 2) Integrated care services REACH-defined as proportion of patients receiving integrated services of those who met specific criteria. Difference in mean REACH between practices was evaluated using t test.
  
  
  RESULTS
  Overall, 26.2% of target patients (n = 24,906) were assessed for integrated care and 41% (n = 836) of eligible patients received integration services. Practices that implemented systematic protocols to identify patients needing integrated care had a significantly higher screening REACH (mean, 70%; 95% CI [confidence interval], 46.6-93.4%) compared with practices that used clinicians' discretion (mean, 7.9%; 95% CI, 0.6-15.1; P = .0014). Integrated care services REACH was higher among practices that used clinicians' discretion compared with those that assessed patients systematically (mean, 95.8 vs 53.8%; P = .03).
  
  
  CONCLUSIONS
  REACH of integrated care interventions differed by practices' method of assessing patients. Measuring REACH is important to evaluate the extent to which integration efforts affect patient care and can help demonstrate the impact of integrated care to payers and policy makers.
authors.affiliation: From the Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas Regional Campus, Dallas (BAB); Department of Family Medicine, University of Colorado School of Medicine, Aurora (DF, LMD, BFM); Department of Family Medicine, Oregon Health & Science University (RG) and Oregon Rural Practice-Cased Research Network, Portland (MD); Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, Somerset, NJ and Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ (BFC); Department of Family Medicine and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC). bijal.a.balasubramanian@uth.tmc.edu.
authors.forename: Bijal A
authors.initials: BA
authors.lastname: Balasubramanian
authors.affiliation: From the Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas Regional Campus, Dallas (BAB); Department of Family Medicine, University of Colorado School of Medicine, Aurora (DF, LMD, BFM); Department of Family Medicine, Oregon Health & Science University (RG) and Oregon Rural Practice-Cased Research Network, Portland (MD); Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, Somerset, NJ and Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ (BFC); Department of Family Medicine and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC).
authors.forename: Douglas
authors.initials: D
authors.lastname: Fernald
authors.affiliation: From the Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas Regional Campus, Dallas (BAB); Department of Family Medicine, University of Colorado School of Medicine, Aurora (DF, LMD, BFM); Department of Family Medicine, Oregon Health & Science University (RG) and Oregon Rural Practice-Cased Research Network, Portland (MD); Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, Somerset, NJ and Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ (BFC); Department of Family Medicine and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC).
authors.forename: L Miriam
authors.initials: LM
authors.lastname: Dickinson
authors.affiliation: From the Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas Regional Campus, Dallas (BAB); Department of Family Medicine, University of Colorado School of Medicine, Aurora (DF, LMD, BFM); Department of Family Medicine, Oregon Health & Science University (RG) and Oregon Rural Practice-Cased Research Network, Portland (MD); Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, Somerset, NJ and Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ (BFC); Department of Family Medicine and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC).
authors.forename: Melinda
authors.initials: M
authors.lastname: Davis
authors.affiliation: From the Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas Regional Campus, Dallas (BAB); Department of Family Medicine, University of Colorado School of Medicine, Aurora (DF, LMD, BFM); Department of Family Medicine, Oregon Health & Science University (RG) and Oregon Rural Practice-Cased Research Network, Portland (MD); Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, Somerset, NJ and Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ (BFC); Department of Family Medicine and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC).
authors.forename: Rose
authors.initials: R
authors.lastname: Gunn
authors.affiliation: From the Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas Regional Campus, Dallas (BAB); Department of Family Medicine, University of Colorado School of Medicine, Aurora (DF, LMD, BFM); Department of Family Medicine, Oregon Health & Science University (RG) and Oregon Rural Practice-Cased Research Network, Portland (MD); Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, Somerset, NJ and Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ (BFC); Department of Family Medicine and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC).
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Crabtree
authors.affiliation: From the Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas Regional Campus, Dallas (BAB); Department of Family Medicine, University of Colorado School of Medicine, Aurora (DF, LMD, BFM); Department of Family Medicine, Oregon Health & Science University (RG) and Oregon Rural Practice-Cased Research Network, Portland (MD); Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, Somerset, NJ and Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ (BFC); Department of Family Medicine and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC).
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Miller
authors.affiliation: From the Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas Regional Campus, Dallas (BAB); Department of Family Medicine, University of Colorado School of Medicine, Aurora (DF, LMD, BFM); Department of Family Medicine, Oregon Health & Science University (RG) and Oregon Rural Practice-Cased Research Network, Portland (MD); Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, Somerset, NJ and Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ (BFC); Department of Family Medicine and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC).
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Cohen
mesh_terms: D003156:Community Mental Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D011216:Practice Management, Medical / Q000458:organization & administration / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D015397:Program Evaluation; D014481:United States
keywords: Delivery of Health Care; Evaluation Studies; Health Plan Implementation; Integrated; Primary Health Care