American Health Policy Institute

Collaborative Care Model Reduces Total Health Care Costs

An HR Policy-supported issue brief evaluating findings from three studies found overall health care cost reductions, at times up to 13%, when collaborative care models, which integrate primary care and behavioral health experts -- were implemented for behavioral health conditions. 

Why it matters: Claims data of 21 million commercially insured individuals found that the 5.7% of individuals with behavioral health and medical/surgical claims accounted for 44% of total health care costs. This demonstrates that controlling behavioral health conditions likely reduces the need for physical health care services and lowers total health care costs for employers.

How it helps: Most behavioral health conditions are treated in a primary care setting; however primary care providers rarely have the appropriate training or tools to effectively manage behavioral health conditions. The Collaborative Care Model provides primary care providers with psychiatric consultations and a care manager to ensure individuals are treated appropriately.

Increases access to behavioral health services: In 2022, over 59 million adults reported having a behavioral health condition but close to half received no treatment for the condition. For those that do receive behavioral health care, more than half of them receive it in a primary care setting. Even more surprising is that the majority of psychiatric drugs are prescribed by primary care physicians, not psychiatrists.

What’s next: The brief found that plans can incur savings within the first year of implementing the Collaborative Care Model, and savings may increase over 3-4 years. Employers should consider evaluating whether providers they contract with utilize this and other integrated care models to reduce overall health care spending. HR Policy continues to advocate for funding to increase technical assistance for providers that want to implement the model.

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Authors: Margaret Faso