Chesterfield, Mo.-based Mercy has spent the past five years scaling a collaborative care management model across roughly 300 clinics in four states. Its goal has been to integrate behavioral health into routine medical care while working through payer adoption, technology alignment and physician leadership challenges, Patty Morrow, vice president of behavioral health services, told Becker’s.
“We have been on a multi-year journey to do this, and we’ve really taken the approach of going essentially region by region, and each state has its own nuance,” she said. “Where our footprint exists, there are payer nuances, workforce nuances.”
The system has spent the last four years leveraging relationships with payers and state Medicaid programs to “move the needle” on how services are reimbursed, Ms. Morrow said. Missouri Medicaid, for instance, initially did not recognize collaborative care codes. Through government relations, internal payer partnership and other stakeholders, Mercy helped push for code adoption. Ms. Morrow said this successful reimbursement created a sustainable path forward.
A crucial element has been physician leadership, she added.
“If it’s just a behavioral health division or a psychiatry arm that is going to primary care and saying we need you to adopt this program… without the joint representation of primary care leadership, I think you’re going to fail, quite frankly,” Ms. Morrow said.
She noted most patients with a chronic disease and a behavioral health comorbidity drive higher cost and utilization to the healthcare system. This model aims to chip away at those patterns and drive down costs through integrated care.
“It’s a much more affordable way to deliver care within the primary care setting,” she said. “If we get a patient in the ER that is connected to our primary care network, we are also able to warmly hand them off, if it’s appropriate clinically, back to primary care, where we can continue to manage those patients in a collaborative care approach.”
Technology has been one of the biggest learning points, Ms. Morrow said.
Mercy adopted Epic’s behavioral health module, which includes collaborative care components for registry, billing and clinical tools to support standardized tests such as the PHQ-9 and GAD-7.
“Our goals really are to go deeper into behavioral health integration, especially continuing our work in primary care, but also in specialty areas like oncology, women’s health, cardiology,” Ms. Morrow said. “How can we create more channels in natural environments for the patient and bring solutions to them?”
