F4b - Collaborative Family Healthcare Association

Session #F4b
Saturday, October 18, 2014
Cost Assessment of
Collaborative Healthcare
Shandra Brown Levey, PhD, Clinical Psychologist
Emma Gilchrist, MPH, Project Manager
Warren Pettine, Medical Student
University of Colorado Denver Department of Family Medicine
Collaborative Family Healthcare Association 16th Annual Conference
October 16-18, 2014
Washington, DC U.S.A.
Faculty Disclosure
• We have not had any relevant financial relationships
during the past 12 months.
Learning Objectives
At the conclusion of this session, the participant will be able to:
• Describe a novel approach to calculating the cost of
• Discuss the benefits of a multidisciplinary team in
developing integrated care initiatives.
• Identify the policy implications of assessing cost for
integrated care.
Bibliography / Reference
Chapkoa MK, Liu CF, Perkins M, Li YF, Fortney JC, Maciejewski ML. Equivalence of two
healthcare costing methods: bottom-up and top-down. Health Econ. 2009; 18: 1188–1201
James BC, Savitz LA. How Intermountain trimmed health care costs through robust quality
improvement efforts. Health Affairs. 2011;30(6):1185-1191.
Kaplan RS, Porter ME. How to solve the cost crisis in health care. Harvard Business Review.
Katon W, Russo J, Lin EH, et al. Cost-effectiveness of a multicondition collaborative care
intervention: a randomized controlled trial. Archives of general psychiatry. 2012;69(5):506-514.
Manderscheid RW, Alexandre P, Everett A, Leaf P, Zablotsky B, Eaton W. American mental
health services: perspective through care patterns for 100 adults, with aggregate facility,
service, and cost estimates. Public mental health. 2012:381.
Porter ME. What is value in health care? New England Journal of Medicine.
Ritzwoller DP, Sukhanova A, Gaglio B, Glasgow RE. Costing behavioral interventions: a
practical guide to enhance translation. Ann Behav Med. Apr 2009;37(2):218-227.
Learning Assessment
• A learning assessment is required for CE
• A question and answer period will be
conducted at the end of this presentation.
CoACH Origins
• Prescription for Health/ACT/SHAPE
• Work with practices to determine the cost of integrating
to determine a global payment
• CoACH automates this process and provide a tool for
interested practices to determine financial factors and
workflow associated with integration activities
Developed by multidisciplinary team
Public Health
Actuarial Science
Integrated Primary Care Practices
• Input from primary care providers, behavioral health providers,
practice managers, medical assistants, front desk staff, CFOs,
CoACH: Cost Assessment of Collaborative Healthcare
• On-line tool to determine the estimated incremental
expenditure of integrating behavioral health and
primary care.
• Practices are asked to work with others in their
organization for improved accuracy of estimates.
• Practices receive:
• an estimated incremental expenditure to complete the
work proposed
• the building blocks for an accurate and adjustable
• average reimbursed amounts across payer types based on
the Colorado APCD data by month and year
Some information CoACH requires
Payer mix percentages by practice
Estimations for FTE of involved personnel
Average monthly mid-point salaries and benefits
Number of patients in the practice
Types of collaborative or integrated care
activities the practice currently does or plans to
• Estimated time per week providers and staff
participate in integrated care activities
Tips for Completing CoACH
• CoACH can be paused and returned to using a link sent
to the email address practices provide.
• Working with a team to complete CoACH can help
improve accuracy input regarding integration activities,
personnel responsible for activities, and activity time
Policy Implications
• All participants in the health care system need
objective, evidence-based information to make
critical decisions about how to allocate health
care resources.
State Policymakers
Federal Policymakers
Session Evaluation
Please complete and return the
evaluation form to the classroom monitor
before leaving this session.
Thank you!

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