全球智库信息集成服务系统

Capacity for Care

• The center was not designed to be fully integrated. One side serves veterans, while the other side is available to service members, veterans, and their families but primarily serves family members. Each side has separate entrances, information systems, and processes for monitoring performance.
• The partnership between the two sides of the UBHC allows for convenient access to behavioral health services for veterans and family members and facilitates exchange of information between the different sides, which can improve coordination of care.

Barriers to Implementation and Service Delivery

• Coordinating the construction of a new facility was challenging because of numerous regulatory considerations.
• Some collaborative activities are not institutionalized and codified (e.g., a liaison between sides of the center).

Services Delivered

• The two sides of the center had different patterns of service utilization: The VA side provided fewer services to a larger number of individuals, and the private health center side provided more-intensive services to fewer individuals. As a result, the overall number of patient encounters was comparable, despite very different patient loads.
• Both sides succeeded in becoming operational and delivering a substantial amount of services (more than 7,000 behavioral health encounters on each side of the center) in the three years since opening.

Patient Outcomes

• UBHC patients consistently expressed satisfaction with their experiences at the center and the care they received.
• Adult and child patients treated on the private health center side showed improvement in key behavioral health outcomes.

Many veterans and their families struggle with behavioral health problems, family reintegration difficulties, and relationship problems. Although many veterans are eligible to receive care at Department of Veterans Affairs health facilities, family members are generally not eligible and therefore must seek care elsewhere. This situation can pose a barrier to family members' access to care and also make it more difficult for veterans and families to receive high-quality services that are coordinated across providers.

A new model of behavioral health care is trying to address these barriers: Created by the Northwell Health System and the Northport Veterans Affairs Medical Center, the Unified Behavioral Health Center (UBHC) for Military Veterans and Their Families in New York state is a public-private partnership that is providing colocated and coordinated care for veterans and their families.

RAND evaluated the center's activities to document the implementation of a unique public-private collaborative approach for providing care to veterans and their families. The first component of the evaluation focused on documenting the structures of care (the capacities and resources that the center developed and employed) and the processes of care (the services delivered). The second component focused on outcomes of care. The evaluation suggests that, overall, the model has been successfully implemented by the UBHC and has great potential to be helpful to the veterans and families it serves.

• Chapter One

  Background

• Chapter Two

  Evaluating the Unified Behavioral Health Center for Military Veterans and Their Families: Methodological Approach

• Chapter Three

  The Center's Creation and Capacity for Care

• Chapter Four

  Processes of Care: Services Delivered and Patient Characteristics

• Chapter Five

  Patient Experiences and Outcomes

• Chapter Six

  Lessons Learned, Recommendations, and Conclusions