Poster 29 – Using Collaborative Care to Drive Improvements in Behavioral Health, Nutrition and Fitness in Medicare Patients in Cardiology Clinics

Cardiovascular health is strongly linked to psychological health and the accumulation of evidence has recently led national cardiology organizations to recommend screening for mental health issues as part of cardiology best practices. We propose using Collaborative Care (CoC) as an implementation solution to deliver behavioral health screening and treatment within cardiology and expand the traditionally narrow treatment focused on behavioral health to also include nutrition and fitness. After 1 year of phased program implementation in a Medicare population, patients’ average depression scores decreased 51%, anxiety scores 58%, and insomnia scores 39%. Average minutes of daily exercise increased from 8.6 to 30.2, days per week of physical activity increased from 1.7 to 4.6, and Five-Times-Sit-to-Stand test time decreased 28%, or by 4 seconds. Average weight loss was 6.7lbs, systolic blood pressure decreased 9 mmHg, diastolic 4.5 mmHg, and significant decreases were seen in HbA1C, cholesterol, and triglycerides, albeit with smaller numbers of patients. The program was acceptable to participants with overall care rating of 4.88 out of 5. Additionally, ordering providers integrated this treatment pathway into existing care delivery workflows with minimal disruption for clinic staff. Income from CoC added an additional revenue stream of that improved practices’ financial stability. Future program improvements will be aimed at modifying the nutrition program to improve weight loss outcomes. Overall, CoC proved effective in delivering behavioral risk modification in a Medicare population in cardiology settings and allowed participating clinics to meet new best practices for the screening and treatment of behavioral health conditions.