Michigan Cities Lead in Collaborative Mental Health Care Models

Three cities in Michigan—Jackson, Ann Arbor, and Saginaw—are recognized nationally for their effective models of integrating mental health care into primary health care settings. Advocates for this collaborative care approach argue that it can prevent up to 14,000 deaths each year by increasing access to mental health services.

A recent study by Path Forward, a Washington D.C.-based advocacy group, found that only about 100,000 out of nearly 60 million adults and children with mild to moderate mental health conditions utilized this collaborative model in 2022. This model, which combines the expertise of primary care providers, behavioral health care managers, and psychiatric consultants, aims to create a seamless experience for patients seeking mental health support.

In terms of participation, Michigan has shown remarkable growth since adopting this model. In 2018, only 44 providers billed for collaborative care, serving around 100 patients. By 2022, these numbers had risen to 430 providers and 1,640 patients. Jackson ranked first in the nation for patients receiving collaborative care under Medicare Advantage and second for those on Original Medicare. Ann Arbor and Saginaw also ranked high among cities for patient participation in this model.

Anna Bobb, executive director of Path Forward, emphasized Michigan’s leadership in this area, stating, “There are some real winners in the nation, and one of those is Michigan.”

The shortage of mental health professionals in the United States has created barriers to timely care, particularly in rural and underserved areas. Many individuals who die by suicide have consulted primary care providers shortly before their deaths, highlighting the need for integrated care.

Bobb pointed out that there is often a 10-year gap between the onset of mental health symptoms and diagnosis, which can lead to crisis situations. The collaborative care model aims to narrow this gap, allowing for earlier intervention and treatment.

Research shows that patients enrolled in collaborative care programs see a 50% reduction in suicide risk. This model also allows psychiatrists to manage their time more effectively, enabling them to treat up to eight times more patients than in traditional settings.

Despite its benefits, transitioning to a collaborative care model presents challenges. Health systems must adapt workflows, recruit new team members, and adjust billing practices. However, Bobb noted that after the transition, the model shows sustained effectiveness in improving patient outcomes.

In 2017, dedicated billing codes were established for collaborative care, facilitating insurance reimbursement. Michigan is one of 22 states that have activated these billing codes for Medicaid and the Children’s Health Insurance Program (CHIP). This progress, along with strong insurance reimbursement policies and philanthropic support, has contributed to the state’s successes in mental health care integration.

Looking ahead, advocates are pushing for increased Medicare reimbursement rates to further incentivize the integration of behavioral health into primary care. The Complete Care Act, introduced in the U.S. Senate earlier this year, aims to provide these incentives for three years. As of now, the bill is under review by the Senate Finance Committee.

In summary, Michigan’s collaborative care model demonstrates a promising path for improving mental health care access and effectiveness, particularly in preventing crises and enhancing early intervention strategies.