As the U.S. senior population grows, behavioral health conditions among older adults are becoming increasingly common. Anxiety, depression, and substance use disorders now affect a significant portion of adults aged 65 and older. In response, providers are prioritizing integrated behavioral health care for seniors, combining mental health support with traditional medical services to improve overall well-being. Two leaders in this area, Elara Caring and Oak Street Health (NYSE: OSH), are setting the standard for innovative, patient-centered approaches.
Texas-based Elara Caring operates across 16 states, providing home health, hospice, personal care, palliative care, and behavioral health services. The organization works with Medicare, Medicaid, and commercial payers, making it a versatile option for seniors with different insurance plans. Meanwhile, Oak Street Health focuses on value-based primary care for adults on Medicare. As of November, the Chicago-based provider operated 161 centers across 21 states, caring for over 145,000 at-risk patients. Both providers are making integrated behavioral health care for seniors a core part of their strategies.
Behavioral health challenges among older adults are rising rapidly. According to the Kaiser Family Foundation, more than a quarter of adults ages 65 to 74 report feelings of anxiety or depression. Meanwhile, CDC data shows that drug overdose deaths among adults aged 65 and older have tripled over the past 20 years. These trends highlight the critical need for senior care providers to offer integrated behavioral health care for seniors as part of comprehensive services.
The Benefits of Collaborative Care for Seniors
Collaborative care models benefit both seniors and providers. Katherine Suberlak, vice president of clinical services at Oak Street Health, emphasized the importance of a holistic approach during Aging Media Network’s Continuum conference: “It’s hard to separate the head from the rest of the body.” Mental and physical health are deeply connected, and addressing both simultaneously improves outcomes for patients.
Many seniors already have strong relationships with their primary care providers. By embedding behavioral health into these existing relationships, providers can increase trust and access to care, especially in underserved communities where mental health resources may be limited.
Integrated care also has financial advantages. Untreated mental illness can prevent patients from attending appointments, adhering to medications, or managing chronic conditions, ultimately increasing healthcare costs. Providers that prioritize integrated behavioral health care for seniors can improve patient outcomes while reducing downstream expenditures.
Oak Street Health’s Integrated Model
Oak Street Health has implemented a collaborative care model that universally screens all patients for mental health and substance use disorders. All counties the company serves are designated mental health provider shortage areas, making these services crucial. Nearly half of Oak Street’s patients are dually eligible for Medicare and Medicaid, and many manage seven or more chronic conditions.
Patients needing behavioral health support are proactively enrolled with an on-site qualified mental health professional who is part of the primary care team. A virtual network of psychiatric providers supports escalation when needed, creating a care triad of primary care provider, psychiatrist, and mental health professional. Oak Street reports that 73% of patients in its collaborative care program experience sustained reductions in depression six months post-treatment.
By integrating behavioral health from the outset when opening new centers, Oak Street ensures that mental health specialists are fully embedded into care teams. “Rather than integrating after an opening, integrating from the start,” Suberlak said. In 2021, Oak Street invested nearly $350 million in its centers and surrounding communities to ensure behavioral health was a core service. This approach exemplifies effective integrated behavioral health care for seniors in practice.
Elara Caring’s In-Home Behavioral Health Programs
Elara Caring also emphasizes integrated behavioral health care for seniors, focusing on both medical and mental health during in-home visits. The provider conducts roughly 100,000 visits annually for patients with serious mental illness or substance use disorders.
Its Embrace program supports seniors coping with loss—whether of a loved one, independence, home, or other major life changes. Patients can access Embrace at home, in skilled nursing facilities, or in senior living communities. Joe Cramer, president of hospice and behavioral health at Elara Caring, noted that nearly half of seniors entering care facilities have elevated anxiety or depression. Embrace addresses these challenges alongside medical needs, reinforcing the importance of integrated behavioral health care for seniors.
Traditionally, home health and hospice providers prioritized medical care first, treating behavioral health as secondary. Elara flips this model by addressing mental health in parallel with medical care. The Embrace program has achieved a 78% reduction or stabilization of patient anxiety and depression, highlighting the effectiveness of integrated behavioral health care for seniors in home and facility-based settings.
Looking ahead, Elara plans to expand behavioral health services across all states where it operates. The provider aims to partner with ACO Medicare groups and Medicare Advantage plans while implementing additional training programs for staff to support comprehensive care. This demonstrates how integrated behavioral health care for seniors can scale successfully across large, multi-state networks.
Why Behavioral Health Integration Matters
The growing behavioral health needs of the senior population are clear. Untreated mental health issues can exacerbate chronic conditions, increase hospitalizations, and drive up healthcare costs. By implementing integrated behavioral health care for seniors, providers like Oak Street Health and Elara Caring improve access, patient satisfaction, and overall outcomes. Programs like Oak Street’s collaborative care model and Elara Caring’s Embrace initiative provide practical examples of how behavioral health can be fully integrated into senior care.
Treating mental and physical health together ensures seniors receive comprehensive, patient-centered care. Integrated care models also empower providers to manage costs more effectively, reduce hospital readmissions, and improve quality metrics. As the senior population grows and behavioral health challenges become more widespread, investment in integrated behavioral health care for seniors is no longer optional—it is essential for high-quality, sustainable care.
