reverse-apa-medical-mind

Model Legislation for Private Insurance Coverage of the Psychiatric Collaborative Care Model (CoCM) Codes

Over the past decade, the integration of behavioral health and general medical services has been shown to improve patient outcomes, increase access to mental health and substance use treatment, increase patient and provider satisfaction, save money, and reduce stigma related to mental health. Significant research spanning three decades has identified one model – the Collaborative Care Model – in particular, as being effective and efficient in delivering integrated care.

APA has created legislation that would increase access to mental healthcare by having private insurers reimburse Collaborative Care billing codes. Legislation has been drafted for all 50 states and the District of Columbia and is designed to be a positive legislative solution for addressing access to care while being budget-neutral for the state. Each state has legislation that is tailored specifically for that state's terminology and formatting.

How Does It Work?

The Collaborative Care team is led by a primary care provider and includes a behavioral health care manager and consulting psychiatrist. The five essential elements include:

  1. Patient-Centered Team Care
  2. Population-Based Care
  3. Measurement-Based Treatment
  4. Evidence-Based Casev
  5. Accountable Care

This model has over 90 randomized control trials that demonstrate its effectiveness and efficiency. Additionally, research has shown that the Collaborative Care Model has proven more cost effective than treatment as usual, saving $6.50 USD in healthcare costs for every $1 USD spent for depression.

To learn more about the Collaborative Care Model, or to take the online training on how to work in the Collaborative Care model, please visit psychiatry.org/collaborate

Top

State Model Collaborative Care Legislation Adapted to All 50 States and the District of Columbia

One of the American Psychiatric Association’s major legislative goals is to increase access to mental healthcare across the country. APA encourages measurement and evidence-based solutions to address access to care, like the Collaborative Care Model, which has over 90 randomized clinical trials demonstrating its efficiency and effectiveness.

In this model, a care team, led by a primary care provider and including a behavioral health care manager and consulting psychiatrist, work together to provider mental healthcare to a broader group of patients using innovative tools like a patient registry and evidence and measurement-based care.

Not only does the model increase access to mental healthcare, but it does so in a way that ensures that the patient is engaged in their treatment and receives high quality care. Specifying that private insurers reimburse the Collaborative Care billing codes is a positive legislative solution for addressing access to care while being budget-neutral for the state.

APA has drafted model legislation that would do just this, and it has been specifically adapted for each state by amending the appropriate sections of state code or creating new sections in the right titles or chapters. Additionally, each bill is formatted exactly as bills are drafted in that state.

Find your state's comprehensive model parity legislation:

Top

Contact APA's Department of Government Relations Team

For more information on how your state can get involved in legislation addressing access to mental health care, please contact:

Erin Berry Philp, APA Director of Government Relations: ephilp@psych.org
Tim Clement (Northeast – Region 1): tclement@psych.org
Amanda Chesley Blecha (Midwest – Region 2): achesley@psych.org
Marsi Thrash (South – Region 3): mthrash@psych.org
Tim Miller (West – Region 4): tmiller@psych.org

To learn more about the Collaborative Care Model or to receive training in how to work in the Collaborative Care model, please visit psychiatry.org/collaborate or contact Michelle Dirst at mdirst@psych.org.

Top