Collaborative Care Designation Program: Increasing access to behavioral health care

Our country is facing a national behavioral health emergency. According to Mental Health America:

• 57.2% of adults with a mental illness didn’t receive treatment in 2020. That means more than 26 million individuals experiencing a mental illness are going untreated.
• Since 2011, nearly a quarter of all adults with a mental illness reported they weren’t able to receive the treatment they needed.
• The access issue doesn’t only affect adults: 59% of youth with major depression didn’t receive any mental health treatment in 2020.

To help address this crisis, Blue Cross Blue Shield of Michigan is expanding the use of the Collaborative Care Model, which we wrote about in a previous Record article, to create a statewide Collaborative Care Designation Program this year. The Designation Program builds on the Patient-Centered Medical Home foundation and provides training, support and financial incentives to eligible PGIP practitioners as they implement and deliver Collaborative Care in their primary care practices.

To receive CoCM designation, a primary care practice must already have PCMH designation and must meet Collaborative Care-specific capabilities. These capabilities reflect elements that a practice needs to effectively deliver CoCM.

How the program works

• The CoCM program uses a care team that includes a primary care provider, behavioral health care manager and a consulting psychiatrist.
• The primary care provider makes all decisions regarding the patient’s treatment plan and remains the head of the care team.
• The behavioral health care manager works closely with the primary care provider and participates in treatment planning, talks with the patient about their response to treatment, alerts the doctor when the patient isn’t improving and regularly meets with the consulting psychiatrist to discuss treatment progress.
• The consulting psychiatrist reviews the patient caseload with the behavioral health care manager and suggests treatment modifications. The consulting psychiatrist doesn’t normally see the patient or prescribe the medications but provides clinical expertise remotely as part of an overall effort to ensure appropriate care.

Effectiveness of the model

CoCM has high levels of patient and provider satisfaction — and Blue Cross is receiving positive feedback from practices implementing CoCM as well as from patients participating in the program. Here’s an excerpt from one provider testimonial:

Dr. Amy McKenzie, vice president for clinical partnerships and associate chief medical officer, said: “Treating the whole person with a coordinated multidisciplinary team in the primary care setting improves access to care in a setting that’s convenient and affordable while improving outcomes at a time when behavioral health needs are at an all-time high. Strong provider relationships provide the foundation for growing our CoCM program.”

The Collaborative Care Model has been shown to be twice as effective for treating depression and anxiety than traditional care. It’s been shown that effectively integrating physical and mental health care through a model such as CoCM reduces overall health care spend.

By the numbers

Currently, 180 primary care practices across Michigan are delivering CoCM, with 84 added last year. After a 2021 adolescent pilot, a supplemental adolescent training track was developed and was opened to all interested CoCM practices in 2022.

To encourage participation, physician organizations, practices and providers are offered PGIP incentives as well as value-based reimbursement for individual providers.

A total of 190 practices have been nominated for designation over the past year. CoCM-designated practices will be announced later this year. Watch for more details in the September-October issue of this newsletter.

For more information

• To learn more about PCMH, visit the Patient-Centered Medical Home section of valuepartnerships.com.
• If you’re currently in PGIP and are interested in delivering CoCM, please contact your PGIP physician organization for more information.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.