Collaborative care and integrated care: What’s the difference?

How using one term over another could affect psychologists’ payment rates.

As a practicing psychologist, you may have heard or used the phrase “collaborative care” to describe an integrated approach to delivering health care that involves working on a team or alongside other providers. Payers, insurers and other clinicians, however, may confuse your practice with the American Psychiatric Association’s “Collaborative Care Model” or CoCM.

Because the CoCM is a specific framework, the American Psychological Association and the Practice Organization encourage psychologists to use the term “integrated care” to describe how psychologists work in collaborative environments. To learn more, watch a video on “Knowing Your Terminology: Integrated Care and Collaborative Care."

Integrated care more accurately reflects the role psychologists play in the delivery of patient healthcare, and places psychologists in a better position in the health care industry.

 

Collaborative care or Collaborative Care Model?

Why practice integrated care?Psychologists often collaborate with physicians and other health care providers to improve a mutual patient’s care. The CoCM, however, more narrowly defines “collaborative care.”  In this model, psychologists are seen as “care managers,” not as doctors. The CoCM does not allow psychologists to work at the top of their license, putting them on par with licensed social workers, registered nurses, nurse practitioners or licensed mental health counselors, who may also work as care managers.

This may result in lower reimbursement rates for psychologists working within psychiatry’s model. The CoCM model is also linked to certain current procedural terminology codes that psychologists cannot use to bill for reimbursement.

Psychologists have a robust reach and a distinct impact on health care. Efforts to advocate for psychologists center on creating a distinction between collaborative care and integrated health care.

Are you collaborative or integrated?

Many psychologists work (e.g. collaborate) with other health care professionals to enhance patient care. In the broadest sense, there are multiple ways of providing psychological care in conjunction with these other providers:

  • Coordinated care involves an arrangement where psychologists, physicians, hospitals and other providers come together voluntarily and share the responsibility for providing care. Psychologists typically remain autonomous, independent providers whose involvement is through referrals and consultation.
  • Co-located care occurs when a practicing psychologist rents or uses a space where other health care providers practice. This allows psychologists to remain autonomous but enables them to work in tandem with other providers to treat patients. (See recorded webinar on co-location with Helen Coons, PhD.)
  • Integrated care involves the highest degree of collaboration and communication among psychologists and other health care professionals. Psychologists are official members of the team and often share the same EHRs. Psychologists who practice integrated care work alongside physicians as colleagues and team members in hospitals, primary care settings and other specialty health care practices.

Psychologists working in integrated care settings should not refer to their practice as “collaborative care.”

Integrated care training for APA and Practice Organization members

The Centers for Medicare and Medicaid services provided APA with funding to train more than 6,000 psychologists to work in integrated health care. All costs for this training opportunity are covered by the CMS funding. The training program is administered by APA’s Center for Psychology and Health.

To register for APA’s free integrated care training provided by the Integrated Health Care Alliance, please visit their website.