In our current healthcare system, the treatment of medical illness and behavioral health conditions, including mental health and substance use disorders, are treated as discrete problems as though they were not occurring in the same person. While mental illness should be treated in conjunction with other medical conditions, it is left undetected and untreated most of the time by medical providers who increasingly have little time to manage complex medical problems. There is also a scarcity of mental health resources and psychiatrists making access to behavioral health care difficult. Consequently, untreated mental illness takes an enormous toll on individuals and our healthcare system including exacerbations of underlying medical conditions, increased mortality and excessive consumption of healthcare resources leading to substantially increased costs. Consider the following:
Enhancing health care quality, access and value, including psychiatric services, requires employing a new model of care with organized, proactive approaches to individuals’ and populations’ health.
It is the position of the NJPA that:
In the Primary Care setting, the NJPA recognizes a model of integrated care known as the Collaborative Care Model (CoCM) as the most effective approach with demonstrated positive outcomes and cost containment across different mental health diagnoses and treatment locations. This model enables enhanced access to the available psychiatric workforce to provide improved care outside the traditional psychiatric settings. CoCM offers a team-based approach and includes primary care providers, behavioral health care managers (BHCM) and psychiatric consultants attentive to psychosocial needs, cultural differences and healthcare equity. The primary care provider prescribes psychiatric medication with support and consultation from the BHCM and consulting psychiatrist. The consulting psychiatrist, who does not see patients directly, will provide caseload consultation to the BHCM for several hours each week thereby leveraging psychiatric support among a large number of patients. CoCM is population-focused with universal screenings for targeted psychiatric illness, measurement-guided to ensure that all patients get better and an accountable model of care where outcomes are closely tracked in a registry with no patient falling through the cracks. With over 100 randomized control studies, CoCM is evidence based resulting in demonstrably improved outcomes for the vast majority of patients.
The Collaborative Care Model results in the following:
The NJPA recommends all insurance carriers and NJ Medicaid provide reimbursement for CoCM CPT codes. These CPT codes are billed by primary care physicians and cover the cost of behavioral care services provided by behavioral health care managers and psychiatric consultants integrated in primary care practices.
While the New Jersey Psychiatric Association (NJPA) makes every effort to post accurate and reliable information, it does not guarantee that the information on this website is complete, accurate or up to date, nor does it assume responsibility for the use or application of any posted material. The NJPA takes no responsibility for any error, omission or other discrepancy between the electronic and any printed versions of documents. This website is intended solely for the purpose of electronically providing members, non-member psychiatrists and the public with information and convenient access to a variety of resources. The NJPA cannot provide specific advice or counsel, whether medical, legal or otherwise. This website links to websites maintained by other entities. Although efforts have been taken to assure that these linked websites are maintained by reputable organizations, the NJPA is not responsible for the information and opinions expressed in those linked sites.