The collaborative care model (CoCM), which integrates physical and behavioral health services, may help reduce the total cost of patient care.
That’s according to a new report from the Bowman Family Foundation, which zeroed in on research published by University of Washington (IMPACT) and the University of Pennsylvania/Independence Blue Cross (Penn/IBC) and Kaiser Permanente.
“While each of these studies has limitations, taken together (using different patient populations, payer mixes and health plan types), they provide evidence that implementing CoCM in day-to-day primary care is associated with reductions in total health care costs (THCs), and that such reductions may occur as early as the first year and may increase over 3-4 years,” authors of the report write.
Mental health and substance use disorder services remain much more difficult to access than physical health care. Many patients often rely on primary care providers for behavioral health needs.
The report highlights that PCPs prescribe the majority of psychiatric drugs. Additionally, individuals with physical and behavioral health comorbidities have a higher total cost of care.
In a collaborative care model, primary care physicians remain the main point person responsible for the care of a patient with a mental health or substance use disorder but are supported by behavioral health professionals.
“CoCM also significantly increases the capacity of the existing mental health and substance use disorder (MHSUD) delivery system,” the report said. “One “full-time equivalent” psychiatric consultant can effectively impact MHSUD treatment for as many as 3 – 8 times more patients under CoCM than could be achieved through traditional 1:1 treatment.”
In addition to improved care, the report highlights the potential financial benefits of a CoCM. Specifically, it points to an unpublished study by Kaiser Permanente Colorado, which compared patients enrolled in the plan’s Depression Care Management program that were receiving CoCM in primary care practices to those receiving the standard of care.
The research found a 13% per-member-per-month savings in the total cost of care associated with members enrolled in the CoCM compared to the standard of care group.
The report makes several recommendations to boost CoCM in the future. For starters it encourages states not already reimbursing for CoCM to do so, and that the rates should be on par with Medicare reimbursement rates.
It also encourages commercial providers to incentivize the model by reimbursing at least 30% higher than Medicare rates. Additionally, the authors of the report suggest that for both Medicare and commercial patients, there is no cost-sharing associated with CoCM services.