Sustaining Healthcare Across Integrated Primary Care Efforts (SHAPE)

Integrated health care addresses the whole health of patients and drives better health outcomes, but there is insufficient evidence on how to best pay for integrated behavioral health in primary care. The Farley Center partnered with the Collaborative Family Healthcare Association and Rocky Mountain Health Plans (RMHP), with funding from The Colorado Health Foundation, to support investment in integrated care. Three SHAPE practices in Western Colorado received payments to cover the costs of integration, calculated using an activitybased costing method rather than the more common fee-for-service model.

Patients at practices receiving the SHAPE payments were 3.5 times more likely to be screened for depression. RMHP provided payments totaling $900,000 to the SHAPE practices. Net savings to public payers (Medicaid and Medicare) totaled $1.08 million after 18 months. These project outcomes demonstrate that alternative payment models support behavioral health integration and can lead to cost savings for public payers.

Based on the project’s success, RMHP developed a formal tiering structure to direct alternative payments for behavioral health integration to advanced primary care practices. These findings provide evidence for how payers can support integrated behavioral health through alternative payment models to achieve better care and cost savings. Results like these are useful in the Farley Center’s continued efforts to promote payment reform as a critical tool for integrating behavioral health.

FROM 2012-2015

$1.08M 3.5x

Net savings to public payers after 18 months

More likely to screen patients for depression