Cracking the codes: state Medicaid approaches to reimbursing psychiatric collaborative care

Cracking the codes: state Medicaid approaches to reimbursing psychiatric collaborative care

Collection:
Health Policy and Services Research
Author(s):
Raney, Lori, author
Contributor(s):
California HealthCare Foundation, issuing body.
Publication:
[Oakland, CA] : California Health Care Foundation, September 2020
Language(s):
English
Format:
Text
Subject(s):
Behavior Therapy
Intersectoral Collaboration
Medicaid
Medicare
Psychiatric Rehabilitation
California
United States
Genre(s):
Technical Report
Abstract:
Integrating behavioral health into primary care is an important way to increase access to effective behavioral health treatment while maximizing the capacity of our very limited behavioral health workforce. There are many approaches to integration, but the Collaborative Care Model (CoCM) has the most robust evidence base, especially for anxiety and depression. Compared to the usual primary care approach to managing behavioral health needs, in which a provider either refers the patient to a specialist or manages needs on their own, CoCM offers supports for the providers and delivers superior clinical outcomes for common, less complex behavioral health conditions. This paper examines the progress of states whose Medicaid agencies are reimbursing the CoCM codes to identify lessons learned and best practices, and to inform the approaches of other states in the future. While the focus of this paper is on state-level implementation, the approaches and lessons learned also apply to individual Medicaid managed care plans, which have the flexibility to pay for integrated care using these codes or other value-based payment approaches in many states. For example, at least one of Oregon’s Medicaid Coordinated Care Organizations has elected to reimburse the codes, and in Chicago, the Medical Home Network accountable care organization reinvested savings from its risk-based payer contracts to implement collaborative care.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
Extent:
1 online resource (1 PDF file (27 pages))
Illustrations:
Illustrations
NLM Unique ID:
9918366885406676 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/9918366885406676