Collaborative Care Cost-Sharing and Referral Rates in Colorado.
Med Care
; 62(9): 624-627, 2024 Sep 01.
Article
in En
| MEDLINE
| ID: mdl-38986112
ABSTRACT
BACKGROUND:
Collaborative care integrates mental health treatment into primary care and has been shown effective. Yet even in states where its use has been encouraged, take-up remains low and there are potential financial barriers to care.OBJECTIVE:
Describe patient out-of-pocket costs and variations in referral patterns for collaborative care in Colorado. RESEARCHDESIGN:
Retrospective observational study using administrative medical claims data to identify outpatient visits with collaborative care. For individuals with ≥1 visit, we measure spending and visits at the month level. Among physicians with billings for collaborative care, we measure prevalence of eligible patients with collaborative care utilization.SUBJECTS:
Patients with Medicare, Medicare Advantage, or commercial health insurance in Colorado, 2018-2019.OUTCOMES:
Out-of-pocket costs (enrollee payments to clinicians), total spending (insurer+enrollee payments to clinicians), percent of patients billed collaborative care.RESULTS:
Median total spending (insurer+patient cost) was $48.32 (IQR $41-$53). Median out-of-pocket cost per month in collaborative care was $8.35 per visit (IQR $0-$10). Patients with commercial insurance paid the most per month (median $15); patients with Medicare Advantage paid the least (median $0). Among clinicians billing for collaborative care (n=193), a mean of 12 percent of eligible patients utilized collaborative care; family practice and advanced practice clinicians' patients utilized it most often.CONCLUSIONS:
Collaborative care remains underused with fewer than 1 in 6 potentially eligible patients receiving care in this setting. Out-of-pocket costs varied, though were generally low; uncertainty about costs may contribute to low uptake.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Primary Health Care
/
Referral and Consultation
/
Cost Sharing
/
Health Expenditures
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Med Care
Year:
2024
Document type:
Article