医疗保险中协作式护理模式和一般行为健康整合服务的提供。
Provision of Collaborative Care Model and General Behavioral Health Integration Services in Medicare.
机构信息
Department of Medicine (Marcotte, Reddy, Zhou, Liao) and Department of Psychiatry and Behavioral Science (Razliff, Unützer, Chang), School of Medicine, University of Washington, Seattle; Value and Systems Science Lab, Seattle (Marcotte, Reddy, Zhou, Liao).
出版信息
Psychiatr Serv. 2021 Jul 1;72(7):822-825. doi: 10.1176/appi.ps.202000265. Epub 2021 Apr 15.
OBJECTIVE
The authors sought to describe the early use of collaborative care model (CoCM) and general behavioral health integration (BHI) billing codes among clinicians.
METHODS
Counts and payments were calculated for accepted and denied claims for CoCM and general BHI services delivered to Medicare beneficiaries nationwide in 2017-2018. Payment and utilization data were stratified by clinical specialty and site of service.
RESULTS
Overall, 10,294 CoCM and general BHI services were delivered in 2017, totaling $626,292 in payments, and 81,433 CoCM and general BHI services were delivered in 2018, totaling $7,442,985 in payments. Medicare denied 5% of services in 2017 and 32% in 2018. Most CoCM and general BHI services were delivered by primary care physicians in office-based settings.
CONCLUSIONS
This study of codes designed to promote BHI revealed an eightfold increase in CoCM and general BHI use between 2017 and 2018. However, denied services represent a barrier, and use among eligible beneficiaries remains low.
目的
作者旨在描述临床医生对协作式护理模式（CoCM）和一般行为健康整合（BHI）计费代码的早期使用情况。
方法
计算了 2017-2018 年间向全国医疗保险受益人群提供的 CoCM 和一般 BHI 服务的已接受和被拒绝的计费的数量和支付金额。根据临床专业和服务地点对支付和使用数据进行了分层。
结果
总体而言，2017 年提供了 10294 次 CoCM 和一般 BHI 服务，支付总额为 626292 美元，2018 年提供了 81433 次 CoCM 和一般 BHI 服务，支付总额为 7442985 美元。2017 年医疗保险拒绝了 5%的服务，2018 年拒绝了 32%的服务。大多数 CoCM 和一般 BHI 服务由在办公室环境中工作的初级保健医生提供。
结论
本研究对旨在促进 BHI 的代码进行了研究，发现 2017 年至 2018 年间 CoCM 和一般 BHI 的使用增加了八倍。然而，被拒绝的服务代表了一个障碍，且符合条件的受益人群中的使用仍然很低。
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