Washington Integrated Care Assessment (WA-ICA) Analysis and Findings

June 18, 2024

March 21, 2024

HealthierHere is excited to share the findings from the Washington Integrated Care Assessment (WA-ICA). This assessment is key to understanding the barriers and supports needed to integrate behavioral health care and primary care. Read on to learn more about the WA-ICA, HealthierHere’s work analyzing the results, next steps, and to access the reports.

What is integrated care?

Integrated care combines efforts across various health professions to ensure a comprehensive care continuum for a patient across their lifetime. For example, by equally integrating behavioral health services into primary care services (and vice versa), patients receive better whole person care. According to UW School of Nursing, whole person care “addresses the physical, emotional, social, and spiritual dimensions of the person to relieve suffering and promote healing in acute and chronic illness.” It is therefore important to advance integrated care further across sectors, and to continually assess and address barriers to achieving integrated care.

What is the Washington Integrated Care Assessment (WA-ICA)?

The Washington Integrated Care Assessment is an assessment framework for Behavioral Health (BH) and Primary Care (PC) providers across Washington State to assess their current level of BH-PC integration and readiness to integrate further. It comprises both quantitative (characteristic) and qualitative (narrative) questions, and has been adapted from the work of Dr. Henry Chung and the framework for Continuum-Based Behavioral Health Integration and General Health Integration in Behavioral Health Settings. The assessment was completed between July-August 2022 by 126 BH sites and 79 PC sites across Washington state.

HealthierHere’s work with the WA-ICA

From December 2022-June 2023, HealthierHere collaborated with UW MPH student Lindsey McClellan on her master’s capstone project, supervised by HealthierHere's Data Analytics Manager Heeju Suh. McClellan analyzed the WA-ICA's over 1300 qualitative (narrative) responses and ranked these often complex and interdependent themes by frequency using Tableau. Lindsey’s analysis provides insight into the current state of integrated care and what supports are needed to better provide integrated care in Washington.

Assessment Findings from the Reports

On a statewide and regional level, most behavioral sites are in earlier stages of integration compared to primary care sites. Primary care sites with an intermediate or more advanced stage of integration readiness are more strongly poised for further integration. Barriers to primary care integration included workforce shortages, and financial strain.

In King County, the biggest barriers to integration readiness at behavioral health sites include the need for billing and receiving reimbursement for immunizations, screenings, and treatments. Zero behavioral health sites surveyed in Cohort 1 bill for these services. Behavioral health sites cited workforce shortages, limited functionality in electronic health records (EHR) systems, financial strain, and lack of population health tools (such as electronic referrals and shared care plans) as the biggest barriers to integration.

What’s next?

Now that key opportunities for advancing integration have been identified for Washington State, the next step is to call on wide-reaching bodies, including health systems, funders, government entities, and other oversight organizations and associations to develop tailored training and assistance for behavioral and primary care providers. We hope that the findings from these reports serve as a resource for building pathways to improve integrated care across the state.

For more information, please contact the WA-ICA at IntegratedCareAssessment@hca.wa.gov