The Impact of Practice Transformation Intervention on Patient Health Outcomes and Primary Care Integration

A study published in the Annals of Family Medicine found that completing different stages of a practice transformation intervention had varying impacts on patient health outcomes and primary care integration in primary care practices across the United States.

Integrated behavioral health (IBH) models, which typically have a behavioral health provider embedded in the practice to work collaboratively with primary care clinicians, have been associated with improved patient outcomes and experience of care, although implementing evidence-based models can be challenging.

The study design involved a large-scale, pragmatic, cluster clinical trial that randomized primary care practices into 1 of 2 arms to test an intervention to increase IBH services. Eligible primary care practices had to meet specific criteria, and eligible patients had specific chronic conditions. The intervention arm received the integrated behavioral health-primary care (IBH-PC) toolkit, which included workbooks, online education, an online learning community, and remote coaching. 

Patient health outcomes and practice integration outcomes were measured using various tools and surveys at baseline, midpoint, and 2-year follow-up. Statistical analysis was conducted using multilevel mixed-effects models to evaluate the association between the number of intervention stages completed and patient-reported and practice integration outcomes.

No significant differences were found between the number of intervention stages completed and patient health outcomes. However, completing each stage was linked to higher scores in Practice Integration Profile domains of workflow (3.5), integration methods (4.6), patient identification (2.9), and total integration (2.7), with corresponding confidence intervals.

“A practice-centric flexible practice transformation intervention improved integration of behavioral health in primary care across heterogeneous primary care practices treating patients with multiple chronic conditions when accounting for completion of intervention stages,” researchers said. “Interventions that allow practices to flexibly improve care have the potential to help complex patient populations. Future research is needed to determine how to best target patient health outcomes at the population level.” 

Reference 
Stephens KA, van Eeghen C, Zheng Z, et al. Intervention stage completion and behavioral health outcomes: an integrated behavioral health and primary care randomized pragmatic trial. Ann Fam Med. 2025;(1):35-43. doi:10.1370/afm.230576