The concept of "integrated care” seems to have joined the ranks of
smartphones and iPads. Like those nifty devices, integrated care is
innovative, effective and sought-after -- yet, not everyone can afford
In plain English, integrated care is a way of providing health care
services that engages individuals and their caregivers in the full range
of physical, psychological, social, preventive and therapeutic factors
necessary for a healthy life. Within health circles, integrated care has
become "all the rage” in Colorado. To illustrate the proliferation of
integrated care, the Colorado Behavioral Healthcare Council mapped some of the numerous efforts underway to integrate physical health and behavioral health care services.
Supporting the delivery of integrated care has been a funding priority for the Colorado Health Foundation in
recent years. Yet, while grantees rave about the positive impact
integrated care services have on patient health and provider morale,
they consistently report it is difficult to maintain these kind of
services due to reimbursement limitations and the complex nature of
billing health plans. National data tells a similar story. A 2010
article in Psychosomatic Medicine by
Roger Kathol, MD, concluded that correcting disparate physical and
behavioral health reimbursement practices is crucial for the survival of
On April 8, the Colorado Health Foundation along with the
Collaborative Family Healthcare Association, the Colorado Psychological
Association and the Colorado Academy of Family Physicians convened a
summit of nearly 100 Colorado primary care and behavioral health
providers, health plan administrators, nonprofit leaders and
policymakers to talk about the challenges associated with sustaining the
delivery of integrated care services.
Here are some of the conclusions summit participants reached on how
to make integrated care the expected standard of care for all
- Change culture of behavioral health -- Negative judgments of those
with a mental health condition or substance-use disorder persist among
the general public as well as health care and social service providers;
despite knowing these conditions can be treated and prevented like any
other health condition.
- Train providers to deliver integrated care -- Most physical and
behavioral health providers have not been trained to work together in
teams to provide integrated care services.
- Test new payment models – Current reimbursement practices hinder the
ability of physical and behavioral health providers to work effectively
as teams to deliver timely care to patients.
- Get support of the business community -- As employers, businesses
are significant purchasers of health care services and can benefit the
most from positive health outcomes and cost savings associated with
- Encourage public to demand change – Many individuals have not had
the opportunity to experience integrated care. Therefore, they do not
know that it is the optimal way to deliver care.
The Colorado Health Foundation is partnering with the Collaborative
Family Healthcare Association to take a closer look at the financial
barriers impeding the delivery of integrated care services. Over the
next year, Collaborative Family Healthcare Association will work with a
broad group of Colorado stakeholders to summarize the financial barriers
to integrated care delivery; identify potential policy fixes; and build
a financial case for changing current reimbursement practices.
Hopefully, this new effort will help move integrated care from "the next cool thing” to the normal way of doing business.
Cassidy Smith is a public policy officer at the Colorado Health
Foundation where she works with a broad group of stakeholders to advance
public policies to improve access to quality, affordable health care
services. Before joining the Foundation, she was special project
coordinator in the Medicaid office at the Colorado Department of Health
Care Policy and Financing. Cassidy earned her master's degree in Health
Policy and Administration from the University of Illinois School of