The 'Coordinated & Integrated' Care Continuum
Larry Cesare, Psy.D. Senior Associate, OPEN MINDS July 31, 2012
Developed by OPEN MINDS, 163 York Street, Gettysburg PA 17325, www.openminds.com. All rights reserved.
With increasing payer and consumer interest in "integrated" and "coordinated" care, it is important to understand the range of options to achieve the overarching concept of "collaborative care."
Typically, we think of three models in the collaborative care continuum:
Coordinated care - In this model, medical and behavioral providers deliver care independently of one another, from separate facilities, and using separate documentation, billing and business systems. The "coordinated" aspect of this model relies heavily on remotely sharing information about common patients.
Co-located care - Within this model, medical and behavioral providers still operate independently of each other but have offices in the same location, thus making referrals and communication between primary and behavioral providers more likely, and offering consumers a "one-stop" option for health care needs.
Integrated care - This is the goal of both consumers and payers - medical and behavioral providers are on an established team that operates under the same documentation, financial and business systems, shares cases, communicate regularly, and cooperates to address the full range of the patient's medical, psychological and social issues.
Even within these three models there can be notable differences based on the population(s) served, staffing, patient identification, patient-centeredness, documentation, financing, and outcomes evaluation (for a deeper look into these differences, check out my article in the upcoming August edition of the OPEN MINDS Management Newsletter, "Integrated Primary Medical & Behavioral Care: A Work In Progress"). And, emerging integrated service delivery models such as ACOs, medical homes, and health homes are also operating within any of these three models (see 221 Accountable Care Organizations In Operation all members and Medical Home V. Health Home - Confused? all members).
With increasing collaboration as a "must" in all health and human service systems, the definition of models is an important first step. And, if you have specific questions or comments about these approaches, I would love to hear from you at firstname.lastname@example.org.