Name
Beyond the Basics: Improving Access by Scaling Collaborative Care for SMI and High-Cost Populations
Description

The traditional collaborative care model (CoCM) clearly sets the standard for treatment of mild-to-moderate depression and anxiety in primary care. Our patients with severe mental illness (SMI) who are connected to primary care have traditionally been excluded from CoCM even if they are not linked to current behavioral health services, which has been a frustration point for both primary care providers and patients. We will present a model of care for expanding collaborative care to patients with SMI that respects the tenets of collaborative care, while also adapting to the realities of caring with patients with SMI. This presentation is applicable to clinicians, policy makers, and health administrators involved in fee-for-service and value-based care.

Speakers
Jennifer Hubbard, LCSW
Stephen Warnick, Jr, MD
Content Level
Intermediate
Tags
Collaborative Care Model of Integrated Care, Financing and Operational Sustainability, Substance abuse management
Session Type
Concurrent
Objective 1
Adapt the standard Collaborative Care Model (CoCM) framework to high-acuity populations to bridge the treatment gap for patients with SMI and complex SUD.
Objective 2
Implement specific diagnostic validation tools (such as the CIDI and SCID) and "treat-to-target" metrics (PHQ-9, GAD-7, and PCL-5) to improve clinical accuracy, implement appropriate treatment planning, and ensure precise risk-adjustment coding.
Objective 3
Design a multidisciplinary staffing program that integrates virtual psychiatric expertise with Behavioral Health Care Managers and other team members to mitigate Social Determinants of Health (SDOH), provide evidence-based treatment, and reduce avoidable medical expenses.
Content Reference 1

Fortney JC, Bauer AM, Cerimele JM, et al. Comparison of Teleintegrated Care and Telereferral Care for Treating Complex Psychiatric Disorders in Primary Care: A Pragmatic Randomized Comparative Effectiveness Trial. JAMA Psychiatry. 2021;78(11):1189–1199. doi:10.1001/jamapsychiatry.2021.2318

Content Reference 2

Reilly S, Hobson-Merrett C, Gibbons B, Jones B, Richards D, Plappert H, Gibson J, Green M, Gask L, Huxley PJ, Druss BG, Planner CL. Collaborative care approaches for people with severe mental illness. Cochrane Database Syst Rev. 2024 May 7;5(5):CD009531. doi: 10.1002/14651858.CD009531.pub3. PMID: 38712709; PMCID: PMC11075124.

Content Reference 3

Cerimele JM, Blanchard BE, Johnson M, Russo J, Bauer AM, Veith RC, Unützer J, Fortney JC. Effectiveness of Collaborative Care and Colocated Specialty Care for Bipolar Disorder in Primary Care: A Secondary Analysis of a Randomized Clinical Trial. J Acad Consult Liaison Psychiatry. 2023 Jul-Aug;64(4):349-356. doi: 10.1016/j.jaclp.2023.02.002. Epub 2023 Feb 9. PMID: 36764483; PMCID: PMC10688610.

Content Reference 4

Lee SJ, Crowther E, Keating C, Kulkarni J. What is needed to deliver collaborative care to address comorbidity more effectively for adults with a severe mental illness? Aust N Z J Psychiatry. 2013 Apr;47(4):333-46. doi: 10.1177/0004867412463975. Epub 2012 Oct 17. PMID: 23076548.

Content Reference 5

Fortney JC, Pyne JM, Kimbrell TA, Hudson TJ, Robinson DE, Schneider R, Moore WM, Custer PJ, Grubbs KM, Schnurr PP. Telemedicine-based collaborative care for posttraumatic stress disorder: a randomized clinical trial. JAMA Psychiatry. 2015 Jan;72(1):58-67. doi: 10.1001/jamapsychiatry.2014.1575. Erratum in: JAMA Psychiatry. 2015 Jan;72(1):96. PMID: 25409287.