By Nika Kabiri, J.D., Ph.D.

The sum of the parts is greater than the whole. It’s a cliché for a reason, and one that should be applied to the way we think about health and healthcare. When it comes to an individual’s health, the combination of mental, behavioral and physical health creates a fullness of well-being far beyond those three elements. 

That’s the principle that underlies collaborative care, a model of healthcare that aims to treat mental health issues in concert with physical conditions — not apart from them, as is so often the case. The collaborative care model forms the foundation of Accolade’s Mental Health Integrated Care  and Accolade Care solutions, helping employers tie mental healthcare more holistically into benefit plans and ensure they’re caring for the entirety of their team’s healthcare needs. 

But why does collaborative care work?   

1. Practitioners can accomplish more by working together as a team

Team healthcare has been widely studied in clinical trials and has been shown to improve patient mental health outcomes and dramatically reduce costs over time. Effective mental healthcare is a necessity, and collaborative care incorporates it into primary care, de-stigmatizing mental illness and improving outcomes for patients.  

A sample collaborative care team: 

Collaborative care starts with the simple idea that mental healthcare should be a part of primary care and reaches an elegant solution of how it can be effectively incorporated. It integrates mental health and substance-use care into primary care and utilizes systematic, results-oriented treatment plans. A collaborative care team usually consists of a primary care practitioner, a care manager and a consulting psychiatrist. 

• The primary care provider sees the patient, makes a diagnosis, treats the patient and prescribes medication, referring when necessary. 

• The care manager tracks patient care, monitors outcomes, regularly reviews cases with the consulting psychiatrist and reaches out to the patient as needed. 

• The consulting psychiatrist assists in creating patient care plans with the primary care provider, provides patient consults and regularly reviews caseloads and specific patient cases that are not improving. 

 2. Primary care providers already know their patients

The pre-existing relationship between a patient and a primary care provider (PCP) creates a level of comfort that can allow for an open discussion of mental health concerns. Unlike psychiatric care, primary care is readily available to most people and is a place where many of them are comfortable. When patients go in for a flu vaccination or other routine checkup, they can talk about their anxieties without worrying that they’ll be judged. 

Instead of always referring a patient with mental distress to a psychiatrist, a collaborative care PCP treats a patient’s mental condition with the support of the consulting psychiatrist. The care manager tracks the patient’s treatment and outcomes, regularly consulting the team psychiatrist on patients who are not improving.  

The collaborative care model eliminates common barriers to mental health care, such as stigma in seeking help, insurance issues, lack of available doctors and lack of available appointments. The care manager ensures continuity of care and improves follow through in care for both the patient and the provider.  

Collaborative care does require changes to how care is provided, but it can offer tremendous returns in terms of mental health outcomes and long-term care costs, including financial costs and lost productivity.  

3. Collaborative care is a specific plan that works 

Collaborative care is not an ambiguous idea or an unsupported theory. It is a specific, evidence-based and established treatment plan that has been tested in clinical trials. Five core principles make collaborative care so effective:  

• Patient-centered team care: Primary care and mental healthcare providers work together to create shared treatment plans. These plans include the patient’s goals in addition to clinical outcomes. 

• Defined group care (or population-based care): The care team members (PCP, care manager and consulting psychiatrist) share a defined group of patients. 

• Measurable target treatment care: Patient treatment plans include clear, measurable clinical outcomes and take into account the patient’s personal goals. Outcomes are determined by established evidence-based tools, such as standardized depression scales. The care manager monitors patient results. If a patient’s targeted outcomes are not being met, the care manager and consulting psychiatrist review the case. Coordinating with the PCP, they create a new treatment plan and track the new target outcomes. 

• Evidence-based care: Patient care plans utilize treatments that have been clinically studied and have been shown to be effective, such as behavioral activation therapy, problem solving treatment and medications. 

• Accountable care: Providers are held responsible for their patient care and are compensated for their quality of care, not their quantity of patients. Different pay models have been studied, including fixed payments for care and pay for performance care, which ties a percentage of income to treatment outcomes.  

4. Collaboration is cost effective

Mental health conditions have a very real impact beyond their symptoms. Conditions such as depression have a negative effect on physical health, take a toll on friends and family and reduce workplace productivity. There is a real, and measurable, financial cost to mental illness. 

A long-term study showed that for every $1 spent on collaborative care for depression, $6.50 was saved in overall long-term healthcare costs. An initial investment of $522 in collaborative care during the first year saved $3,363 over four years. That means that collaborative care based-models don’t just help get patients the care they need — they can even help health plans and employers control costs in the bargain.  

Find out how Accolade Care delivers a holistic healthcare experience and download our e-book to learn more.