Presenters
- Shanda Wells, PsyD, Behavioral Health Manager for Primary Care and Adjunct Assistant Professor, Department of Psychiatry & Pediatrics, UW Health, Madison, WI
- Mollie Moore, PhD, Behavioral Health Supervisor for Primary Care, UW Health, Madison, WI
- Tristan Laszewski, BS, Senior Clinical Systems Analyst, UW Health, Madison, WI
- Kathleen McCraw, PhD, Behavioral Health Clinician Lead, UW Health, Madison, WI
- Nivea McElwain, CPC, CUC, Coding Manager, UW Health, Madison, WI
Summary
While significant research has highlighted the clinical value of Integrated Behavioral Health practices to patients and communities (O’Donnell et al., 2013), financial viability often remains a barrier to establishment of these models (Herbst et al., 2018; Miller et al., 2017). While CoCM billing codes established in 2017 have made it possible to bill for services and provider time in potentially more financially sustainable ways (Cross et al., 2019), adoption of these codes by health care systems has been slow and is not without its own challenges (Malâtre-Lansac et al., 2020). In this presentation, we will discuss lessons learned from the adoption and roll out of CoCM billing codes at a large academic medical center system, incorporating both quantitative and narrative perspectives. Quantitative findings include results of a prospective cost analyses comparing psychotherapy codes to Collaborative Care codes, which showed a potential 29.3% increase in revenue, as well as a Strata analysis demonstrating the organization currently makes $20 per Collaborative Care patient based on revenue and both direct and indirect costing models. We also incorporate the viewpoints of multiple individuals involved in the logistical roll out of CoCM codes, with presenters including administration/leadership, information systems, coding, and frontline behavioral health clinicians each speaking to the benefits and challenges of the process from their unique perspectives. We will also discuss the importance of considering value metrics of integrated care in addition to finances, including health care utilization, community well-being, and provision of care to traditionally under-served populations.
Objectives
- List requirements necessary for billing using CoCM codes
- Identify multiple essential stakeholders involved in CoCM adoption
- Explain potential benefits and pitfalls associated with roll out of CoCM billing