Implementation and Dissemination of the Collaborative Care Model to Improve Care of Individuals Diagnosed with Mental Illness and Substance Use Disorders in Pennsylvania

Background:

The CoCM is an evidence-based and team-based approach to physical health and behavioral health integration in primary care settings. CoCM primarily involves collaboration between a primary care provider, a behavioral health care manager (BHCM), and a consulting behavioral health (BH) provider such as a psychiatrist. The UPMC Center for High-Value Health Care (CHVHC) has been subcontracted by the Pennsylvania Department of Human Services to support participating primary care sites in the implementation of CoCM, conduct a program evaluation, engage stakeholders in ways to sustain CoCM following the project, and administratively oversee project activities. This project will focus on individuals with co-occurring mental health conditions and substance use disorders (SUDs).

Healthcare challenge:

Approximately 21.5 million adults in the U.S. have co-occurring conditions, which puts them at a higher risk of developing other health conditions and poor health outcomes.[1] Unfortunately, many individuals with diagnosed co-occurring disorders face difficulties accessing treatments for their mental health conditions and SUDs. Integrating systems of behavioral health services and primary care using CoCMs can help improve access to care and health outcomes and lower health care costs for individuals with co-occurring disorders.

Goals:

·       Increase the capacity of at least three rural primary care practices to integrate behavioral health into existing primary care settings practices throughout the project period.

·       Implement and evaluate the effectiveness of the CoCM in improving patient and provider outcomes in rural PC practices.

·       Identify strategies to sustain and scale the CoCM approach across the Commonwealth.

Implementation Approach:

o   Population: We anticipate serving 1,800 unduplicated individuals with co-occurring mental health conditions and substance use disorders throughout the five-year project period.

o Methodology: As defined by section 520K of the Public Health Services Act, CoCM components include care directed by the primary care team, structured care management, regular assessments of clinical status using appropriate and validated tools, and modification of treatment as appropriate. The CHVHC team will be responsible for managing four core activities to implement this approach:

§ Readiness: Ongoing assessment of barriers, successes, needs, and opportunities.

§ Implementation: Ongoing process of CoCM service delivery to individuals with co-occurring conditions.

§ Evaluation: Ongoing data collection and data analyses to understand outcomes impacted by CoCM services.

§ Engagement: Ongoing discussions with government, community, and health care stakeholders to work toward sustainability and scaling.

Funding for this project was made possible by Grant Number 1H79SM090009-01 from SAMHSA. The views expressed in written materials or publications do not necessarily reflect the official policies of the Department of Health and Human Services, nor does the mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.