The Transformation of the Healthcare System: Integrated Primary Care and the Role of Stepped Care Interventions for Behavioral Health Providers

  • Alexandros MaragakisEmail author
  • Marianthi N. Hatzigeorgiou


Most countries spend a significant portion of their gross domestic product (GDP) on healthcare expenses. As of 2013, the OECD average healthcare expense per GDP was 8.9%, and in the United States (US), one of the most fragmented examples of healthcare, over 16.4% of the nation’s GDP was spent on healthcare expenses (OECD, 2015). Furthermore, healthcare costs are steadily increasing at an annual rate of 3%, well above the inflation rate (Moses et al., 2013). Though US healthcare expenditures surpass that of any other developed country, data indicates that American healthcare fails to achieve proportionately higher outcomes and quality, typically trailing behind many middle-income countries (Berwick, Nolan, & Whittington, 2008; Moses et al., 2013). The mismatch between spending and quality, in conjunction with the ever-increasing costs of healthcare, has spurred the need for reform and has become a major political and social discussion point.


Stepped care interventions Behavioral health in primary care Policy Healthcare systems Integrated care 


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Alexandros Maragakis
    • 1
    Email author
  • Marianthi N. Hatzigeorgiou
    • 2
  1. 1.Eastern Michigan UniversityYpsilantiUSA
  2. 2.University of MichiganAnn ArborUSA

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