Module 2
Integrated Care Models
Collaborative care has among the strongest evidence in delivery redesign and has been paid for since 2017. Why adoption still lags, and how programs quietly degrade.
By the end of this module, you will be able to:
- Cite what the collaborative care trials and systematic review actually found
- Name the operational disciplines a program loses first when it degrades
- Explain how billing codes fund a team through a single claim
- The Evidence for Collaborative Care Collaborative care has among the strongest evidence bases in all of delivery redesign. The trial results are worth knowing precisely. About 5 min
- Making Integration Work Collaborative care fails in practice for predictable reasons. The registry, the caseload review, and the treat-to-target discipline are not optional components. About 5 min
- Paying for Integration Medicare has paid for collaborative care since 2017. Knowing that removes the most common objection and exposes the real one. About 5 min
Module quiz
Answer all questions to see your score.
1. What did the IMPACT trial find at 12 months?
The odds ratio was 3.45, confidence interval 2.71 to 4.38. A Cochrane review later confirmed benefit for depression and anxiety across short, medium, and long-term horizons.
2. What do failing collaborative care programs typically lose first?
Components requiring only a hiring decision survive; components requiring weekly discipline get dropped. What remains looks like collaborative care and performs like usual care.
3. What does the existence of Medicare's collaborative care codes since 2017 tell us?
Payment came in 2017 and adoption remained limited, so the binding constraints are staffing, consultant availability, registry build, and practice change.