ADVANCING BEHAVIORAL HEALTH INTEGRATION IN THE PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)

Sep 28, 2026

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Older adults enrolled in the Program of All-Inclusive Care for the Elderly (PACE) face substantial barriers to accessing behavioral health services despite high comorbidity rates (60%). Behavioral Health Integration in PACE (BHI-PACE) is presented through a conceptual framework and results from a nationwide mixed-methods assessment of Behavioral Health Integration across PACE Organizations. Findings from a national survey (38 responses; 148 POs) and semi-structured interviews (15 POs) identify four framework domains and key practices, challenges, and policy implications.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Background and Need

Behavioral Health Integration Conceptual Framework

Nationwide Mixed-Methods Assessment

Key Findings: Comorbidities, Barriers, and Strategies

Implications for Policy and Implementation Research

Innovation in Aging, 2025, Vol. 9, No. S2 661 SESSION 7020 (POSTER) BIOBEHAVIORAL HEALTH Abstract citation ID: igaf122.2257 ADVANCING BEHAVIORAL HEALTH INTEGRATION IN THE PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Alexa Fleet1, Liane Wardlow2, Daniel Shalev3, Michelle Moses-Eisenstein4, William McGuire5, Kristen Hartlieb2, and Harold Pincus6, 1. University of Massachusetts, Boston, Massachusetts, United States, 2. West Health Policy Institute, San Diego, California, United States, 3. Weill Cornell Medicine, New York, New York, United States, 4. New York State Psychiatric Institute, New York, New York, United States, 5. New York State Office of Mental Health, New York, New York, United States, 6. Columbia University, New York, New York, United States Older adults enrolled in the Program of All-Inclusive Care for the Elderly (PACE) face significant barriers to accessing behavioral health (BH) services despite high rates of BH comorbidities (60%). Integrating BH into PACE programs is critical to achieving truly comprehensive, person-centered care. This poster introduces a conceptual framework for Behavioral Health Integration in PACE (BHI-PACE) and presents current BH practices and challenges within PACE Organizations (POs) from a nationwide assessment. A mixed-methods sequential explanatory approach was used to assess BHI across POs. This study employed (1) a national survey distributed to 148 POs (38 responses, representing 119 PACE sites and 25,806 participants) and (2) semi-structured interviews with 15 POs (representing 58 sites and 10,029 participants). The BHI-PACE framework comprises four domains: (1) Person/Family-Oriented Care, (2) Clinical Functions,(3) Workforce to Support Clinical Functions, and (4) Structures to Support Clinical Functions. Key findings highlight that 60% of PACE participants experience BH comorbidities, with depression (92.1%), behavioral and psychological symptoms of dementia (57.9%), and anxiety disorders (55.3%) as the most common referral reasons. Workforce shortages, insufficient funding structures, and limited integration of BH specialists into POs were identified as primary barriers. However, successful integration strategies include the use of telemedicine, interdisciplinary team collaboration, and formalized external partnerships. This work contributes to both theory and practice by presenting a replicable framework for BH integration in complex care settings for older adults. It informs future policy initiatives, workforce development strategies, and implementation research aimed at improving BH outcomes in aging populations.

FAQs

What problem does the poster address for older adults in PACE programs?

It addresses significant barriers to accessing behavioral health services despite high behavioral health comorbidity rates among older adults enrolled in PACE.

How was Behavioral Health Integration in PACE (BHI-PACE) assessed?

A mixed-methods sequential explanatory approach was used, combining a national survey of 148 POs with semi-structured interviews with 15 POs.

What domains make up the BHI-PACE framework?

The framework includes four domains: Person/Family-Oriented Care, Clinical Functions, Workforce to Support Clinical Functions, and Structures to Support Clinical Functions.

Sep 28, 2026

Uploaded by Aldword