On the frontlines of collaborative care

When a patient’s chronic conditions are compounded by depression, it’s a recipe for adverse outcomes and high healthcare costs. Dr. Paul Ciechanowski, a national leader in developing evidence-based models of collaborative care describes a new way forward. Bringing together care managers and coaches on the frontlines of care with a psychiatrist, the primary care physician, and other clinicians as needed, creates a team that can accelerate care delivery and have a measurable impact on patient outcomes.

We have great intentions...all of us. We want patients to get better, but we can’t make timely and appropriate changes with patients if our model is one person, one visit every 2-3 months.
— Paul Ciechanowski, MD, MPH

Resources

Katon, W.J., Lin, E., Von Korff, M., Ciechanowski, P., et al. Collaborative Care for Patients with Depression and Chronic Illnesses. New England Journal of Medicine, 2010; 363:2611-2620.

Ciechanowski, P., Wagner, E., Schmaling, K., et al. Community-Integrated Home-Based Depression Treatment in Older Adults. JAMA, 2004;291(13):1569-1577.

Collaborative Care Cycle, Samepage Health (PDF)

Centers for Medicare and Medicaid Services (CMS). Medical Learning Network Fact Sheet: Behaviorial Health Integration Services—new CPT codes, January 2018.