Develop a Funding Plan
Your funding plan should be mapped to the populations and conditions to be treated and can vary depending on your setting.
Cost of Collaborative Care
In the IMPACT trial, the cost of providing Collaborative Care for 12 months averaged $580 per patient. This included a care manager, weekly consultation with a psychiatrist and an expert in geriatric medicine, and program materials. The costs of providing Collaborative Care outside of the research study is estimated to be $300-$500 per patient based on:
- Length of program (which can be less than 12 months)
- Number and type of visits (e.g. in-person vs. telephone)
- Type of care management personnel used
For managed care organizations, the cost of offering Collaborative Care as a member benefit is estimated to be less than $1.00 per member per month (PMPM). In Medicare Advantage plans, Collaborative Care can significantly increase capitated payments by documenting diagnoses of and treatment for depression under the new HCC payment system.
Billing and Reimbursement
Billing and reimbursement for the kind of care management services provided in Collaborative Care can be complex. However, there is movement on many fronts to reduce or eliminate this barrier to collaborative care for depression. In nearly all cases, at least some services are reimbursable.
Below are some resources on this issue to help you design a plan that will work for your organization.
- Funding mechanisms for depression care management: opportunities and challenges
- Billing for the evaluation and treatment of adult depression by the primary care physician
- Reimbursement of Mental Health Services in Primary Care Settings
- Find current and new financing mechanisms, structures, and infrastructure for integrated care at SAMHSA-HRSA Center for Integrated Health Solutions Financing page