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Payment for Integrated Care: Challenges and Opportunities.

Katherine Hobbs Knutson¹

¹Department of Psychiatry, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC 27705, USA.

Child and Adolescent Psychiatric Clinics of North America

|September 17, 2017

Summary

Integrated care models require strong team collaboration and care coordination. Capitated payment models are essential for successfully integrating behavioral and physical health services, unlike traditional fee-for-service systems.

Keywords:

Child and adolescent psychiatry Health services Healthcare payment Integrated care

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Area of Science:

Health Services Research
Healthcare Management
Integrated Care Models

Background:

Integrated care delivery systems rely on multidisciplinary teams and care coordination.
Fee-for-service payment models present significant barriers to implementing integrated care.
Existing reimbursement structures often limit the feasibility of comprehensive care integration.

Purpose of the Study:

To examine the role of payment models in integrated care delivery.
To identify effective financial strategies for supporting integrated behavioral and physical health services.
To highlight the potential of capitated payment models in healthcare integration.

Main Methods:

Analysis of integrated care delivery system components.
Review of payment arrangements and their impact on care coordination.
Examination of national examples of integrated care supported by capitation.

Main Results:

Fee-for-service arrangements are largely incompatible with integrated care.
Capitated payment models provide a viable framework for integrating behavioral and physical health services.
Numerous successful integrated care systems utilize capitation.

Conclusions:

Capitated payment is crucial for the success of integrated care delivery.
Shifting from fee-for-service to capitation is necessary for robust care coordination.
Payment reform is a key enabler for effective integrated health services.