Integrated Care Delivery Models: Types, Examples, Essentials

Integrated care delivery models bring together different healthcare services under one coordinated approach. Instead of patients bouncing between disconnected providers, these models connect primary care, behavioral health, specialty services, and support resources into a unified system. The goal is straightforward: better patient outcomes, lower costs, and fewer gaps in care.

This guide walks you through everything you need to know about integrated care delivery models. You'll learn why they matter for healthcare organizations facing rising costs and complex patient needs. We'll break down the main types, from coordinated referrals to fully integrated teams, and show you real examples of what works in hospitals and clinics. You'll get practical implementation steps, from choosing the right model for your organization to managing vendor networks and coordinating workflows across teams. We'll also cover the common challenges you'll face, the technology and infrastructure that enable success, and the specific metrics that prove your investment is paying off. By the end, you'll have a clear roadmap for bringing integrated care to your organization.

Why integrated care delivery models matter

You face mounting pressure to reduce costs while improving patient outcomes. Fragmented care costs the U.S. healthcare system roughly $290 billion annually when behavioral health conditions go untreated in primary care settings. Patients with comorbid physical and mental health conditions show higher complication rates, longer hospital stays, and increased readmissions when their care isn't coordinated. Your organization pays the price through higher utilization, poor outcomes, and frustrated care teams.

Integrated care delivery models solve these problems by connecting services that traditionally operate in silos. When you bring behavioral health specialists directly into primary care settings, patients get help during the same visit instead of falling through referral gaps. Your care teams communicate in real time rather than playing phone tag across separate systems. Clinical data flows freely between providers, eliminating duplicate tests and conflicting treatment plans. This coordination cuts administrative waste while catching problems before they escalate into expensive emergencies.

Coordinated care reduces unnecessary emergency department visits, prevents avoidable hospitalizations, and keeps patients healthier between appointments.

The operational benefits extend beyond cost savings. Your staff spends less time on paperwork and more time delivering care. Patients report higher satisfaction when they receive comprehensive support at one location. Your organization meets quality metrics more consistently and reduces the compliance burden of managing disconnected vendor networks. These models transform how you deliver care while positioning your organization for value-based payment contracts.

How to implement an integrated care delivery model

You need a structured approach to transform disconnected services into coordinated care. Implementation requires careful planning across clinical workflows, technology systems, and vendor relationships. Your success depends on starting with clear objectives and building the infrastructure that supports collaboration between previously siloed teams.

Assess your current state and define objectives

Start by mapping every patient touchpoint across your organization. Identify where care breaks down between primary care, behavioral health, specialty services, and support resources like transportation or home health. Document the time your staff spends on phone calls, manual scheduling, and chasing referrals. Calculate the costs of delayed discharges, repeated tests, and patients lost to follow-up. This baseline shows you exactly where integrated care delivery models will generate the biggest returns.

Next, set specific measurable goals for your integration effort. Target reducing discharge coordination time by a concrete percentage or cutting readmissions for patients with complex conditions. Define what success looks like for your care teams: fewer administrative tasks, better patient outcomes, or improved satisfaction scores. These objectives guide every decision you make about which services to integrate first and how to structure your implementation timeline.

Clear baseline metrics and specific goals prevent scope creep and keep your team focused on outcomes that matter.

Build your team and infrastructure

Assemble a cross-functional implementation team that includes primary care providers, behavioral health specialists, care coordinators, IT staff, and operations leaders. Assign clear roles for each phase of implementation. Your team needs a physician champion who can address clinical concerns, a project manager who tracks milestones, and technical leads who handle system integrations. Schedule regular meetings to address barriers before they derail progress.

Invest in technology that connects workflows across your organization. Your platform should enable real-time communication between care teams, automate scheduling for multiple services, and provide visibility into patient logistics from hospital to home. Look for systems that integrate with your existing EHR and billing platforms rather than creating new data silos. The right infrastructure eliminates the manual coordination work that currently bogs down your staff and creates gaps in patient care. Start with a pilot program in one department or for one patient population before rolling out organization-wide.

Key types of integrated care delivery models

You can choose from three main integrated care delivery models, each offering different levels of coordination and resource commitment. The right choice depends on your organization's current infrastructure, patient population needs, and available resources. Understanding these distinctions helps you select a model that matches your operational capacity while delivering meaningful improvements in patient outcomes.

Coordinated care model

Your care teams work from separate physical locations but maintain active communication about shared patients. Primary care providers and behavioral health specialists coordinate through phone calls, secure messaging, or shared electronic health records. When a patient needs mental health support, you refer them to a behavioral health partner and follow up to ensure they attend appointments. This model requires minimal infrastructure investment but depends heavily on strong relationships between independent providers.

Coordinated care works best when you're starting your integration journey with limited budget for facility changes. You maintain existing workflows while adding communication protocols that prevent patients from falling through referral gaps. Your staff learns to collaborate across organizational boundaries without the complexity of shared space or unified scheduling systems.

Co-located care model

You place behavioral health specialists in the same physical location as your primary care team. Patients see their primary care provider and then meet with a behavioral health consultant during the same visit through a warm handoff. Both providers access the same electronic health record and communicate face-to-face about treatment plans. This arrangement dramatically improves patient access to mental health services while keeping providers operationally independent.

Co-located models eliminate the transportation and scheduling barriers that cause 50-70% of behavioral health referrals to fail.

Your organization needs dedicated space for behavioral health staff and updated workflows for same-day appointments. The investment pays off through higher completion rates for behavioral health interventions and better coordination between physical and mental health treatment plans.

Fully integrated care model

Your care teams operate as one unified unit with shared goals, budgets, and clinical protocols. Behavioral health specialists attend morning huddles with primary care providers, participate in care planning, and follow shared patient registries. You track outcomes across both physical and mental health conditions using integrated data systems. This model represents the highest level of coordination in integrated care delivery models and generates the strongest improvements in patient outcomes.

Implementation requires significant organizational change. You need unified governance structures, combined funding streams, and care protocols that guide team-based decision making. Your technology platform must support real-time collaboration and provide visibility into all services a patient receives across your organization.

Examples of integrated care in real settings

Real healthcare organizations use integrated care delivery models to transform patient outcomes and operational efficiency. These examples demonstrate how different settings apply coordination, co-location, and full integration to solve specific challenges. You can adapt these approaches to match your organization's capacity and patient population needs.

Kaiser Permanente's fully integrated system

Kaiser Permanente operates one of the largest fully integrated care systems in the United States, combining health coverage, medical facilities, and physician groups under unified governance. Your patients receive coordinated care through connected teams where physicians, specialists, and behavioral health professionals share the same electronic health record and work toward shared quality metrics. The system eliminates fragmented billing and referral gaps by paying medical groups through capitated arrangements rather than fee-for-service payments. This structure incentivizes prevention and early intervention instead of volume-based care, resulting in lower hospitalization rates and better management of chronic conditions across their eight million members.

Primary care behavioral health in community clinics

Community health centers implement the Primary Care Behavioral Health model by embedding licensed behavioral health consultants directly in exam rooms. Your primary care providers complete medical assessments and then introduce patients to behavioral health consultants through warm handoffs during the same appointment. These consultants deliver brief interventions for conditions ranging from anxiety and depression to diabetes management and sleep disorders. The model targets improving access to mental health support since traditional referrals to specialty behavioral health fail 50-70% of the time. Clinics report reducing behavioral health appointment wait times from weeks to minutes while increasing patient engagement with treatment plans.

Collaborative care for depression management

Hospital systems use the Collaborative Care Model to systematically manage depression across their primary care patient population. Your care managers maintain registries of patients who screen positive on standardized tools like the PHQ-9 and track their progress through regular follow-up contacts by phone or in person. Consulting psychiatrists support primary care providers with medication management recommendations without requiring patients to schedule separate specialty appointments. This approach delivers measurable outcome improvements through systematic tracking and protocol-driven treatment adjustments.

Collaborative care models reduce depression symptoms by 50% compared to usual care while costing less per patient than traditional referral pathways.

Enablers challenges and success metrics

You need specific enablers in place before integrated care delivery models succeed, and you must track the right metrics to prove your investment works. Understanding these elements helps you build the infrastructure and processes that support coordination while avoiding the common pitfalls that derail integration efforts. Your organization must balance technology investments with cultural change and stakeholder buy-in to achieve lasting improvements in patient care and operational efficiency.

Technology and infrastructure requirements

Your integrated care delivery models depend on unified data systems that connect previously siloed workflows. You need electronic health records that multiple providers can access in real time, scheduling platforms that coordinate appointments across services, and communication tools that eliminate phone tag between care teams. Secure messaging capabilities let behavioral health consultants and primary care providers discuss patient needs instantly rather than waiting for callback windows. The right technology platform also automates administrative tasks like referral tracking, appointment reminders, and billing reconciliation across multiple service types. Without these foundational systems, your care teams spend excessive time on manual coordination instead of delivering patient care.

Common implementation barriers

Resistance to workflow changes represents your biggest obstacle to successful integration. Clinical staff struggle to adapt when you ask them to collaborate with new team members, use unfamiliar technology, or modify established care protocols. Payment structures create additional friction since traditional fee-for-service reimbursement often fails to cover coordination activities that happen outside billable patient encounters. Your organization also faces regulatory complexity when state licensing requirements or managed care contracts restrict same-day billing for multiple services. Cultural differences between medical and behavioral health professionals further complicate integration when team members operate from divergent training backgrounds and practice norms.

Organizations that address payment reform alongside clinical integration see 3x higher sustainability rates for integrated care programs.

Measuring integration success

You track three categories of metrics to demonstrate value from integrated care delivery models. Patient outcome measures include symptom reduction scores for depression or anxiety, better chronic disease control markers, and lower emergency department utilization rates. Operational efficiency metrics capture reduced discharge coordination time, fewer missed appointments, and decreased administrative burden on care teams. Financial indicators show cost savings per patient, reduced length of stay, and improved collection rates when you simplify billing through unified platforms. You should establish baseline measurements before implementation and track monthly progress toward your specific integration goals.

Next steps for your organization

Start by selecting the integrated care delivery model that matches your current infrastructure and patient needs. Review your baseline metrics and identify one department or patient population where coordination gaps cost the most. Build your cross-functional team and establish communication protocols before investing in major technology changes.

You need platforms that connect scheduling, communication, and logistics across your care teams. VectorCare streamlines patient logistics by coordinating transportation, home care, and durable medical equipment through one unified system. This coordination eliminates the manual work that prevents effective integration while giving you real-time visibility into every patient service.