The New York State OMH supports the implementation of the Collaborative Care model (CoCM), also known as IMPACT, to integrate Behavioral Health into primary care. In CoCM, patients are treated in a familiar setting and have access to behavioral health services right away. Evidence shows that this minimizes loss to follow up that often occurs with external referrals to specialty care. There is a built-in capacity to treat behavioral health, and someone on the team to keep track of patient outcomes, which often improve for both behavioral and physical health conditions.
New York State Delivery System Reform Implementation Project (DSRIP)
DSRIP projects were chosen by New York State Department of Health and approved by The Center for Medicare and Medicaid Services (CMS) for use by Performing Provider Systems (PPS). The overall goal of DSRIP is to reduce avoidable hospital use by 25% through transforming the New York State health care system into a financially viable, high performing system. To transform the system, DSRIP focuses on the provision of high quality, integrated primary, specialty and behavioral health care in the community setting with hospitals used primarily for emergent and tertiary level of services. DSRIP Project 3.a.i. focuses on the integration of primary and behavioral health services, including mental health and substance use treatment. All 25 PPSs are engaged in this project. They were given three models to choose from to determine how they would integrate services:
- PCMH Service Site: Performing provider systems undertaking this project will develop behavioral health services onsite at their 2014 NCQA level 3 PCMH or Advance Primary Care Model practices. Practices that are not at this level should anticipate meeting it by the beginning of Year 3 of DSRIP. This level of integrated and collaborative care will be required to successfully implement this project.
- Behavioral Health Service Site: It is anticipated that the components of this project will mirror those of “1” above with the exception that primary care services will be placed within behavioral health clinics.
- IMPACT: This is an integration project based on the Improving Mood – Providing Access to Collaborative Treatment (IMPACT) model. The IMPACT model, which originates from the University of Washington in Seattle, integrates depression treatment into primary care and improves physical and social functioning, while cutting the overall cost of providing care. Several community-based primary care providers in New York have experience implementing the IMPACT model. In this model, the behavioral health providers do not necessarily physically integrate into the primary care site.
Though the NYS OMH Collaborative Care Medicaid Program aligns with Model 3 of 3.a.i, it is a separate program. Practices participating in DSRIP may receive training support and reimbursement through the OMH program.