Barriers and facilitators to collaborative care implementation within the New York State Collaborative Care Medicaid...

Area of Science:

• Healthcare delivery innovation
• Mental health integration
• Primary care research

Background:

• New York State has supported primary care clinics in adopting the Collaborative Care Model (CoCM) since 2015.
• Support includes outreach, training, technical assistance, and Medicaid billing opportunities.
• This study examines CoCM implementation characteristics and challenges within the state's program.

Purpose of the Study:

• To describe New York State primary care clinic characteristics at each RE-AIM implementation step.
• To identify barriers and facilitators to CoCM implementation for the Collaborative Care Medicaid Program.

Main Methods:

• A mixed-methods approach using surveys and qualitative interviews.
• Clinics categorized by RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) stages.
• Surveys collected data on demographics, payer mix, and billing; interviews explored barriers and facilitators.

Main Results:

• 107 of 1099 clinics completed surveys (9.7% response rate).
• Significant demographic differences observed across RE-AIM steps.
• Key themes from interviews: billing requirements, reimbursement rates, and buy-in to CoCM.

Conclusions:

• Survey demographics align with expectations for New York State primary care.
• Billing and reimbursement rates are perceived barriers, especially with NYS Medicaid.
• Organizational buy-in, including leadership and provider understanding, facilitates CoCM adoption.