Reimbursement: A Barrier for Integrated Mental Health and Primary Care



Models for integrating mental health care into primary care such as the Chronic Care Model (CCM) have been shown to improve both medical and mental health outcomes for patients, but they have not yet been widely put into practice due to barriers created by the current health care reimbursement system. The CCM specifically includes activities that are core components of the model such as care management and provider decision support that are especially difficult to get reimbursed for. The authors of this article present barriers and opportunities for using the CCM in primary care and getting reimbursed for some of the core components within the current fee-for-service system. They also describe alternative emerging payment models including bundled payments that may help support implementing the CCM and similar models of integration. The authors argue that in order for models of integrated mental and physical health care such as the CCM to be widely applied and sustained, new “reimbursement models will need to be negotiated across payers and providers.”

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