“Access, access, access”: pediatric collaborative care takes center stage at Advancing Behavioral Health and Policy Summit

Jason Richie, director of public health, Milken Institute (l), and Meadows Institute’s Vice President of Care Innovation Clare McNutt field questions from the audience at the Advancing Behavioral Health and Policy Summit in Washington, D.C.

The Collaborative Care Model is a poster child for how to do measurement-based care well.”

— Dr. Caroline Carney

Tequila Terry didn’t mince words. There is an “unprecedented need for behavioral health services exacerbated by the COVID-19 pandemic,” said Terry, director of state innovation and population health at the CMS Innovation Center, during a panel discussion at the Advancing Behavioral Health and Policy Summit, held Dec. 5 at the historic Watergate Hotel in Washington, D.C.

At the start of the panel, titled “The Evolution and Progress of Integrated Models of Care,” Terry shared sobering statistics on how that “unprecedented need” is particularly acute among children: One in six children ages 2-8 are likely to be issued a behavioral health diagnosis in elementary school, she said. For children receiving Medicaid benefits through CHIP, one-third are being diagnosed with a behavioral health condition.

What’s worse: only a third of those children are receiving care, Terry said, because of the difficulty families face trying to navigate the complexities of the specialty behavioral health care system and the challenge inherent in early detection, especially among children who may be experiencing chaotic home environments.

All the panelists agreed that these at-risk children would benefit from the Collaborative Care Model (CoCM), which moderator Kristin Kroeger, chief of policy, programs, and partners at the American Psychiatric Association, called the “gold-standard” of integrated behavioral health care.

The Collaborative Care Model integrates mental health care into primary care and pediatric settings and has been shown to be effective in the early identification and treatment of mental health conditions.

“The Collaborative Care Model is a poster child for how to do measurement-based care well and how to use that to drive better outcomes, help close gaps in care, and ultimately provide value in care,” said panelist Dr. Caroline Carney, president of behavioral health and chief medical officer at Magellan Health.

Clare McNutt, the Meadows Institute’s vice president of primary care innovation, agreed.

CoCM “has more than 90 randomized trials showing it is clinically efficacious for patients with mild to moderate depression and anxiety,” McNutt said. Not only are there decades of research to support the model, McNutt said, but Medicare has been reimbursing for CoCM through novel billing codes since 2017 and most major commercial payers have followed suit. State Medicaid plans are headed in the right direction, with 27 states activating the codes as of December 2023.

McNutt said she was further buoyed by the recent introduction of The COMPLETE Care Act, federal legislation that would improve access to behavioral health care in the primary care setting by incentivizing providers to implement integrated care models, such as the Collaborative Care Model.

While there are initial startup costs associated with implementing collaborative care, the model will save providers money in the long run, stressed Carney.

There are cost savings to be realized, McNutt agreed, but even those, she said, can’t compare to the priceless benefit of “access, access, access to quality, evidence-based health care.”