Unpacking the COMPLETE Care Act: The Future of Integrated Care

NeuroFlow convened a panel discussion at the U.S. Capitol to explore how legislation that supports integrated care models, specifically the COMPLETE Care Act, can bridge key gaps in the healthcare system. Integrating physical and behavioral health is proven to drive positive clinical outcomes and reduce healthcare costs, making a profound impact on patient and provider wellbeing. The need to address these issues is more urgent than ever, particularly given the high prevalence of mental health conditions and rising mortality rates in the U.S. 

The expert panel included (featured from left to right in the image above): 

  • Dr. Tom Zaubler, Chief Medical Officer at NeuroFlow
  • Dr. Lisa Rosenthal, Chief of the Division of Consultation Psychiatry, Associate Vice Chair for Clinical Affairs, and Professor of Psychiatry and Behavioral Sciences at Northwestern University
  • Dr. Caroline Carney, President of Behavioral Health and Chief Medical Officer at Magellan Health 
  • Dr. Hani Talebi, Chief Clinical Officer and Senior Vice President for Health System Integration at Meadows Mental Health Policy Institute

The panel explored the critical implications of the Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act. The COMPLETE Care Act would increase Medicare reimbursement for psychiatric collaborative care from 2025 to 2027 to offset the cost of standing up and implementing this evidence-based integrated care model. This landmark legislation could revolutionize healthcare by breaking down long standing silos and is key to delivering faster, more comprehensive care.

Gaps in Healthcare System Lead to High Costs & Inadequate Care

Our current healthcare landscape is marked by a troubling paradox: 60 to 70% of patients with mental health (MH) conditions present in primary care, yet a majority do not receive adequate treatment due to disjointed care systems and a lack of specialized practitioners. This is particularly concerning as depression, the leading causes of disability, and other mental health conditions carry significant economic consequences.

The cost of care for people with both physical and mental health conditions can be two to three times higher than for those without co-occurring conditions. This is due in large part to the high cost of treating and managing chronic diseases, which often co-occur with mental health disorders. Nearly 30% of those with a chronic condition like diabetes, heart disease, or hypertension also have a mental health disorder, which significantly increases overall healthcare costs. Further, there is a long period between when people have symptoms to when they receive mental health treatment. “For children there is an eight to ten year lag to receive treatment for mental health conditions—that’s a lot of suffering that could be prevented if we intervene early,” Talebi said.

Integrated Behavioral Health Care Can Fill These Gaps

The COMPLETE Care Act could offer a robust solution by supporting the integration of mental health into primary care settings, a move with potential to save both lives and resources. Yet adoption of integrated care models faces multiple barriers, including stigma surrounding mental health, an overwhelmed primary care system, and the financial burden of standing up and implementing new integrated care programs. Dr. Rosenthal noted that the legacy of stigma was what led to the silos in treating mental and physical health conditions. As a result of decades of separation, re-integration has been a challenge. Dr. Rosenthal made it clear there is a connection between the two, “our brains are attached to the rest of our bodies” 

For pediatric and adolescent patients, traditional models of care are often insufficient. Dr. Talebi pointed out that early intervention is crucial, and there is a growing body of evidence supporting Collaborative Care Models (CoCM) in pediatric settings. Likewise, transitional age youth—often overlooked—could greatly benefit from integrated care, especially in environments like college campuses. 

While the CoCM model is not a one-size-fits-all solution, it has shown great promise in going beyond treating mild and moderate mental health conditions. Dr. Carney noted the value of these models in supporting patients with serious mental illnesses (SMI) and conditions, particularly supporting them with finding higher levels of care. She highlighted that these models also aid in addressing social determinants of health, helping reduce patients’ struggles with basic social needs.

Moreover, integrated care models provide an opportunity to address critical issues such as suicide prevention. Up to 45% of individuals who died by suicide had contact with their primary care provider within one month of suicide. Hence, embedding mental health services in primary care settings may serve as a preventative measure by providing timely intervention for at-risk individuals. “Up to 15,000 lives could be saved from suicide every year if we widely implement the Collaborative Care Model,” Talebi noted. 

Technology, Policy, and Collaboration Are Key

The panelists emphasized the transformative power of technology in implementing and supporting integrated care models. From streamlining outcomes tracking with digital screening, to automating routine work, technology can significantly ease the burden of care for providers. As Dr. Zaubler explained, technology increases our ability to meet patients where they are, reducing stigma, and enabling access to immediate care.

Patient satisfaction and adherence to treatment have shown a positive correlation with the CoCM model. Dr. Rosenthal shared her experience that the ability to offload some of the primary care provider’s burden with a direct referral and having a dedicated resource to work  with patients on behavioral activation and modification additionally increases provider satisfaction—despite initial concerns in primary care. 

However, to realize the full potential of integrated care, a concerted effort from all stakeholders is crucial. Policymakers need to ensure appropriate legislation, like the COMPLETE Care Act, to help offset the cost of standing up and implementing integrated care models. Likewise, healthcare providers must strive to adhere to evidence-based treatments, while payors should promote adoption of such models by offering fair reimbursement rates and value-based incentives.

Importantly, the panel highlighted the need for better communication between policymakers and those delivering care. Policymakers must understand the ground realities and challenges faced by healthcare providers to craft effective policies. Also, it’s crucial to tackle the ongoing stigma surrounding mental health and recognize it as essential medical care. Integrated care, the panelists argued, is not just a hopeful option but a necessity.

Finally, the experts stressed the importance of extending integrated care into acute care settings and incorporating such models into training programs over time to fully support the continuum of care. In doing so, we can ensure that the delivery of healthcare keeps up with our evolving understanding of mental health and patient needs.

The panelists made a compelling case for the COMPLETE Care Act and the urgent need for more adoption of integrated care models. With better policies, committed stakeholders, and innovative technology, we can look forward to a future where every individual has access to comprehensive, empathetic, and effective healthcare.

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