NY’s Rep Sponsors Bill To Attempt To Close Gap In Mental Health Care Delivery With Collaborative Care Model Where Psychiatrists Provide Care At Physicians’ Offices 

0 Civil Rights, Equality, Health, Local Voices, Morality and Ethics, New York City News, Science and Technology, Staten Island Families, Staten Island News, Staten Islander Exclusive

Share

NY’s Rep Sponsors Bill To Attempt To Close Gap In Mental Health Care Delivery With Collaborative Care Model Where Psychiatrists Provide Care At Physicians’ Offices 

The following questions were asked of the organization regarding the expected effects of this bill and their stance on it.  Answers were provided by Anna Bobb, MPH, Executive Director, the Path Forward coalition. Questions are bold, answers are in italics:

A little confused as to what the treatments are.  The codes [provided in the text of the bill] appear to be for psychiatric consultation.  

Happy to share more.

The Collaborative Care Model integrates behavioral health care within the primary care setting and features a primary care physician, a psychiatric consultant, and behavioral health care manager working together. The team also uses measurement-based care to ensure that patients are progressing and adjusts treatment when they are not. The model has over 100 research studies demonstrating that it improves access, clinical outcomes, and patient satisfaction.

Broader use of the CoCM would also help to address existing behavioral health workforce shortages. By taking a population-based approach to better meet the growing demand for services, the CoCM has the capacity to greatly increase the number of patients who can receive care for mental health and substance use disorders relative to traditional treatment. Allowing psychiatrists to consult on a registry of up to 60 patients via weekly chart review, oversight of medication and therapeutic interventions, and clinical recommendations, the CoCM multiplies the number of patients who benefit from a psychiatrists’ specialized training eight times over, according to research from the Meadows Mental Health Policy Institute. Additionally, since this consultation can be done remotely, psychiatrists can better reach rural populations.

 

To help promote uptake of behavioral health integration in the primary care setting, the COMPLETE Care Act would temporarily increase the Medicare payment for existing integrated care codes to help practices overcome startup costs. It is a logical and much needed step toward ensuring integrated behavioral health care is more widely implemented, so all people can lead healthy, fulfilling lives.

Do such consultations usually, sometimes, rarely, or never lead to pharmaceutical interventions in the expected implementation of the bill? 

Collaborative Care addresses the ongoing workforce shortages that impede patient access. The COMPLETE Care Act would address these issues by helping clinicians and practices adopt innovative integrated delivery models like Collaborative Care that promote better care coordination.

Does this bill cover only conventionally accepted methods of treatment for mental health issues? In other words, does it cover nontraditional treatments such as acupuncture, yoga, bodywork therapies, or any other modalities that show promise in helping to treat mental illness,  once a diagnosis has been arrived at through consultation? Or is the only accepted treatment talk therapy/ consultation or pharmaceuticals? If it is for conventional methods only, is there wide latitude on what techniques can be utilized (CBT, DBT, Jungian psychotherapy, etc)? 

The patient’s care team, not the federal bill, would move forward an appropriate course of treatment. The legislation aims to support the creation of that team.
Who is this bill expected to help the most (what populations or mental disorders are most likely to be helped)? Like, is it expected to help specific groups, such as elder adults or teenagers, for example? Or perhaps specific disorders that are under treated such as depression or anxiety? 

Great question! Big picture, providers use the model to help people with depression, anxiety, and other common mental health problems.

Because Medicare policy has wide impact across health care, we are hopeful that its adoption holds the potential for progress in pediatrics, obstetrics & gynecology, and geriatrics, as well as with other underserved populations.

See more about the evidence-base for special populations here: https://pathforwardcoalition.org/wp-content/uploads/2024/07/11.18.24-COCM-101-FINAL-1.pdf

 

 

  1. Quick overview: What’s Happening RIGHT NOW:

     

  • In New York City: More than 3.2 million adult New Yorkers, more than one-fifth of the adult population, live with mental illness. [ Office of the New York State Comptroller ]
  • For your readership: Congresswoman Nicole Malliotakis is a sponsor of the bipartisan COMPLETE Care Act, which would make mental health screenings as routine as checking blood pressure.
  • The bill supports the Collaborative Care Model — a proven, cost-effective approach that integrates mental health services into everyday doctor’s offices. We estimate 14K lives could be saved from suicide each year if this model were available everywhere.
  • ⭐ Bright Spots for New York State! ⭐ ***Ithaca No. 4 Nationally for Adoption of Collaborative Care in Medicare!***⭐
    • Ithaca, New York: In our new analysis, Ithaca rose to the top for the adoption of Collaborative Care in Medicare. The rate of adoption in Ithaca is 10X the national average. Medicare is the federal health insurance program for older people and those with disabilities. Our report analyzed 387 metropolitan statistical across (MSAs) across all 50 states. In Ithaca, an estimated 558 patients per 100,000 participating and received access to collaborative care, (Page 16, Trends in adoption of the Collaborative Care Model)
  • ⭐ Several factors in New York are driving the adoption of the collaborative care model. 
    • 🔑: New York is among 22 states that have activated codes in the Medicaid program so that this lifesaving mental health care can be paid for.
    • 🔑 The work of our partner, the American Psychiatric Association, has been a key driver in the adoption of these Medicaid payment codes nationally.
  • 🔑 Other factors that drive adoption of the model include: Philanthropy providing technical assistance and implementation grants to local health systems and federally qualified health centers, strong reimbursement policy from commercial insurance, and strong health system adoption and implementation.

 

Following is the press release from the organization about their support of this bill:

Federal Action Needed to Close Mental Health Gaps Despite 10-Fold Growth in Proven Care Model

The COMPLETE Care Act could drive further expansion of the Collaborative Care Model

 


WASHINGTON, DC — A first-ever national analysis reveals a tenfold increase in the commercial health insurance market in the use of the Collaborative Care Model – a proven team-based approach to mental health care that integrates screening, treatment, and psychiatric consultation directly into primary care. The model is available in all 50 states, but access remains limited: an estimated 100,000 people received services as billed for in commercial insurance in 2023, less than 1% of the nearly 60 million adults and children with mild and moderate mental illness who could benefit.
An independent global data analysis firm analyzed five years of claims data for 219 million people – nearly two-thirds of the U.S. population – in a study commissioned by the Meadows Mental Health Policy Institute, on behalf of Path Forward, and in partnership with the American Psychiatric Association.
Path Forward released the following materials today in support of the expansion of the Model:
●   The claims analysis covering 219 million people from 2018 to 2022 for Medicare and Medicaid and 2018 to 2023 for commercial insurance.
●   A heat map developed by Meadows Institute identifying coverage across the nation.
●   A statement urging Congress to pass the COMPLETE Care Act, legislation that would increase Medicare reimbursement to help cover implementation costs, the biggest barrier to broader adoption.
“If every American suffering from depression had access to the Collaborative Care Model, we estimate that approximately 14,000 lives could be saved each year from suicide,” said Andy Keller, the president and CEO of the Meadows Institute. “The Collaborative Care Model is the gold standard for delivering mental health in primary care settings because mental health is, at its core, simply a very important part of health. This model is the single most impactful step we can take to get upstream, before tragedy strikes, to make Americans healthy again.”
In the Collaborative Care Model, a team led by a primary care provider and supported by a behavioral health care manager leverages the time of a psychiatrist consultant to treat up to eight times more patients. The Collaborative Care Model reduces depression recovery times sevenfold, and more than 90 randomized clinical trials have proven the model’s effectiveness. While start-up implementation costs can be a temporary hurdle, the Collaborative Care Model is 100% sustainable with billing codes once it is up and running.
A number of metropolitan areas across the country saw particularly high adoption rates:
· In Jackson, Michigan, the number of patients with Medicare Advantage participating in the Collaborative Care Model is 23.7 times greater than the national average for Medicare Advantage.
· In Prescott Valley-Prescott, Arizona, the number of patients with Medicaid and CHIP participating in the Collaborative Care Model is 26.5 times greater than the national average for Medicaid and CHIP.
· In Sherman-Denison, Texas, the number of patients with commercial insurance participating in the Collaborative Care Model is 8.6 times greater than the average in the commercial market.
“The Collaborative Care Model is an evidence-based, effective, and innovative method of delivering high-quality mental health care to patients in the primary care setting who need it,” said APA CEO and Medical Director Marketa M. Wills, M.D., M.B.A. “Given the ongoing mental health crisis, the opioid epidemic, and high rates of suicide, the widespread implementation of this model is now more essential than ever to reach the growing number of Americans in need of quality mental health services. Simply stated, the more we adopt the Collaborative Care Model, the more patients can access it, and the more lives we will save.”
Nearly one in five U.S. adults experience a mental health disorder each year and 20% of high school students report seriously considering suicide. The findings arrive amid a critical moment for the nation’s mental health.

Following is a second statement on this issue:

Path Forward Statement on the Need for Further Expansion of the Collaborative Care Model
Path Forward released a landmark analysis this week of the nationwide adoption of the Collaborative Care Model (CoCM).
The report shows a tenfold increase between from 2018 to 2022 for Medicare and Medicaid and 2018 to 2023 for commercial insurance in the number of people who are receiving treatment through this proven, evidence-based method of addressing mental health needs in primary and specialty care settings.
As the report demonstrates, we have made significant strides in improving access to desperately needed behavioral health through CoCM since 2018.
However, that same analysis reveals that significant gaps in coverage remain. In 2023, an estimated 100,000 people (72 commercially insured individuals out of 100,000) were receiving care through CoCM nationwide. In particular, rural areas that have historically lacked the appropriate number of behavioral health care professionals lag behind the rest of the country in the adoption of CoCM.
We must seize available opportunities to further expand access to CoCM. That is why the undersigned strongly support passage of the Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act, commonsense, bipartisan legislation that will improve access to timely, effective behavioral health services in primary care settings and help close the coverage gap.
Here are quotes from physicians in support of this model:

“The Collaborative Care Model is an evidence-based, effective, and innovative method of delivering high-quality mental health care to patients in the primary care setting who need it. Given the ongoing mental health crisis, the opioid epidemic and high rates of suicide, the widespread implementation of this model is now more essential than ever to reach the growing number of Americans in need of quality mental health services. Simply stated, the more we adopt the Collaborative Care Model, the more patients can access it, and the more lives we will save.”

— Marketa M. Wills, M.D., M.B.A., CEO, American Psychiatric Association.

“We can’t solve what we can’t see. This map brings much-needed clarity to where Collaborative Care is being delivered—and where urgent gaps remain. With this data in hand, we can align policy, philanthropic funding, and health system implementation to bring equitable mental health care to scale across the country.”

— Celine Coggins, PhD, CEO, The Goodness Web.

“If every American suffering from depression had access to the Collaborative Care Model, we estimate that approximately 14,000 lives could be saved each year from suicide. The Collaborative Care Model is the gold standard for delivering mental health in primary care settings because mental health is, at its core, simply a very important part of health. This model is the single most impactful step we can take to get upstream, before tragedy strikes, to make Americans healthy again.”

— Andy Keller, President and CEO, Meadows Mental Health Policy Institute.

“Investing in the Collaborative Care Model within primary care is essential for employers committed to supporting working families. Research shows that behavioral health screening and care integrated into primary care, not only improve outcomes but reduces costs. It also ensures that employees and their family members receive timely, coordinated support that keeps them healthy, engaged, and productive.”

— Shawn Gremminger, president and CEO, National Alliance of Healthcare Purchaser Coalitions.

“We’ve long known that providing mental health screening and treatment in primary care settings provides opportunities to improve health outcomes. This important new study reinforces this truth and illustrates that implementation of the Collaborative Care Model is growing. As we observe Mental Health Awareness Month throughout May, let’s acknowledge that plenty of room for growth remains.”
—  Chuck Ingoglia, president and CEO, National Council for Mental Wellbeing.
About
Path Forward is a coalition of health care purchasers, clinician associations, health systems, philanthropists, and health-related nonprofits united by one goal: ensuring equitable access to quality mental health and substance use care.
The Meadows Mental Health Policy Institute is an independent, nonpartisan organization that works at the intersection of policy and programs to advance equitable, data-driven mental health solutions nationwide.
The American Psychiatric Association is the nation’s oldest and the world’s largest psychiatric organization with over 39,000 physician members.
Banner Image: Therapy. Image Credit – Priscilla Du Preez 🇨🇦

Share

Tags: , , , , , , , , , , , , , , , , , , , , , , ,

Related posts

There are no comments yet

Why not be the first

Leave a Reply

Your email address will not be published. Required fields are marked *

*

code