Advancing Behavioral Health Integration in Primary Care: Turning Shared Priorities Into Action

The gap between rising demand for behavioral health services and the healthcare system’s ability to deliver timely, coordinated care continues to widen. Nearly 59 million U.S. adults experience mental illness each year, yet about half do not receive treatment—creating significant downstream consequences for patients, families and the broader healthcare system. As the demand for behavioral health services grows, primary care practices are often the first, and sometimes the only, point of access. Yet, fragmentation in how quality is defined and measured limits the ability to scale effective, integrated models of care.

“People with behavioral health conditions tend to have more medical health issues,” says Vivek Garg, MD, MBA, President and CEO of NCQA. “If you have medical health issues and you have poorly supported mental health issues, the medical issues get worse. We’ve gained clarity as a country that this issue affects all of us.”

A New Partnership to Drive Industry Alignment

To address these challenges, NCQA and West Health recently announced a strategic partnership to advance the integration of behavioral health into primary care. The collaboration combines NCQA’s leadership in quality measurement and accountability with West Health’s expertise in care delivery innovation to identify and test a core set of behavioral health quality measures in real‑world settings.

The initiative also includes the formation of a policy solutions coalition as well as payer workgroups to align with state and federal policy initiatives and ongoing advocacy for behavioral health integration.

Improving outcomes will require more than isolated initiatives or one‑off interventions. Sustainable progress depends on alignment across policy, payment, technology and clinical practice, supported by measurement approaches that reflect real‑world care delivery and enable continuous improvement.

“Heroics aren’t going to change the health of our population,” says Dr. Garg. “That is not systematic, and that is not scalable.”

Measurement Gaps Undermine Behavioral Health Integration

Although there is broad agreement that integrating behavioral health into primary care improves outcomes, the field still lacks consensus on how to define and measure high-quality integration. Measurement gaps have made it harder for payers, policymakers and providers to align around shared expectations, creating barriers to scaling models that are proven to work.

Existing measures are often fragmented, overly complex or disconnected from clinical workflows—particularly in primary care settings already strained by workforce shortages, evolving digital requirements and uneven EHR capabilities. Without a clear, usable measurement framework, efforts to improve behavioral health outcomes remain difficult to sustain.

Convening National Leaders: The Advancing Behavioral Health Executive Forum

On April 21, NCQA and West Health convened national leaders from payer organizations, policymaking bodies and health systems in Encinitas, CA, for an Advancing Behavioral Health Executive Forum.

Discussions examined the disconnect between clinician‑driven, measurement‑based care and the process‑heavy metrics often tied to payment and accountability, underscoring the need for stronger alignment across policy, payment technology and clinical practice to support earlier identification and more consistent follow‑up in primary care.

The Forum featured a fireside chat between Dr. Garg and Zia Agha, MD, Chief Medical Officer at West Health Institute, who explored the real‑world barriers to integrating behavioral health into primary care and the system‑level changes needed to move from measurement to system-wide impact.

Moving From Measurement to Better Outcomes

Forum participants emphasized that reducing complexity is essential to driving improvement. The goal is not more measurement—but better measurement that supports clinical decision-making, reduces burden and enables learning over time.

“If you just measure and don’t provide the resources to fill those gaps, we often see resistance,” says Dr. Agha. “The beauty of the integrated care model is that it does make those resource changes in primary care.”

NCQA and West Health will continue working with stakeholders to advance scalable, measurement‑informed approaches that strengthen behavioral health integration in primary care.

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