Brief Description
- Articulate evidence for effectiveness of collaborative care: improved quality and health outcomes.
- Research evidence
- Evidence of large scale implementation in diverse settings (e.g., DIAMOND, RESPECT-MIL, MHIP)
- Specify costs associated with evidence-based integrated care.
- Start-up costs
- Operational costs
- Articulate ‘value’ (benefits and costs) of integrated care in diverse health care settings.
- Cost-effectiveness
- Return on investment
- Identify common variations by practice settings and populations.
- Summarize the ‘business care’ and incentives for use of evidence-based integrated care for patients, providers, practices, payers, purchasers.
Opportunity (Why Now?)
- Take advantage of transformation of primary care (e.g., health homes, ACOs) and other policy changes (parity)
- Collaborative care is mature technology with lots of research and more recently large scale implementation evidence in different settings.
- Growing consensus that care management is a core function of the medical home but variation in how it delivered especially with regards to improving behavioral health outcomes.
- Emerging new payment models, including ACOs
- There is increasing accountability for outcomes in health homes, including behavioral health outcomes.
- Communication and marketing in this area has not been particularly effective.
- Difficulty translating from research to real world implementation to large scale demand and payment which would further advance access to effective patient-centered collaborative care for large populations and improve ‘value’ associated with behavioral health care
More Information
CMS Brief
Henry Harbin, Michael Schoenbaum and Jürgen Unützer wrote a brief and had a meeting with the Center for Medicare and Medicaid Innovation. They proposed a large scale demonstration of payment for evidence-based integrated / collaborative care under Medicare and Medicaid, possibly within the context of current Accountable Care Organization (ACO) and Patient-Centered Medical Home (PCMH) demonstration projects. They have also identified health plans and delivery systems interested in participating in such a demonstration. Letters in support of a large-scale demonstration have been submitted by professional organizations, advocacy groups, health plans, and large medical groups.
