Study Examines CoCM Implementation Barriers and Facilitators

May 1, 2024

The April 2024 study, Barriers and facilitators to collaborative care implementation within the New York State Collaborative Care Medicaid Program, was conducted by the AIMS Center team, Erin LePoire and Ashely Heald. The AIMS Center has worked with New York State’s Learning Network since 2015 to deliver effective Collaborative Care within clinics across the State. Driven by our desire to provide insights into the implementation of the Collaborative Care Model (CoCM), this study highlights what helps and hurts CoCM Implementation. The key findings of this study are as follows:

Facilitators of the Collaborative Care Model

  • Having a dedicated non-clinical staff to handle Medicaid billing and data reporting.
  • Having Primary Care Providers and organization leadership who are supportive and understand the Collaborative Care Model.

Barriers to Collaborative Care Model

  • New York State Medicaid billing requirements are complex and difficult to meet, requiring clinics to build reports, program new electronic health record functionality, and/or have dedicated staff manually track and verify criteria to bill.
  • Clinics were not maximizing their potential reimbursement rates because they were unaware of their options, or did not feel the reimbursement rate justified the work involved in tracking and meeting the billing requirements. 
  • A lack of buy-in and understanding of the Collaborative Care Model from the CoCM Team makes running a successful program impossible. Not understanding the model, inappropriate referral, discomfort in prescribing psychotropic medications, distrust of the Psychiatric Consultant, and favoring traditional psychotherapy over brief, evidence-based behavioral interventions all create barriers to successful implementation.

This study underscores the need for improved billing workflows and increased education, training, and planning around Collaborative Care best practices and financial sustainment. These findings are instrumental in understanding the challenges and opportunities in implementing CoCM and can guide future efforts.