Complimentary from the Center
Written for a practice deciding, not a practice already sold.
- BCBSM + BCN
- Which integration codes do they recognize?
- PGIP
- Does the practice work through a Physician Organization?
- The care manager
- Can a limited-license clinician fill the role?
- CMS model
- What does MLN909432 require?
- Staffing
- Who has to be on the team?
- Billing
- What does each code require?
- Registry
- How do we track a caseload?
- Source notes
- Where did this come from?
No form between you and the Brief. It is yours either way.
The kit walks through the decision: what Collaborative Care asks of a practice, who has to be on the team, what a month of care looks like, how payment works, and where implementation can get difficult. Where the evidence is thin, it says so.
Figure 01
The practice can see the referral. It cannot always see what happens next.
The referral ends the practice’s view of the care. The care itself continues somewhere else.
This figure shows a gap in visibility, not a measured failure rate. Measuring what happens after referral is part of this study.
Two ways care can be organized.
Both begin with the same patient in the same room. They differ in where the follow-up happens, and in what the medical practice can see.
External referral
- Who follows up
- Patient and receiving provider
- Where the mental health plan lives
- Usually outside the referring practice’s record
- What the medical practice sees
- Depends on whether information returns
Integrated care
- Who follows up
- A care manager on the team
- Where the mental health plan lives
- Connected to the medical record
- What the medical practice sees
- Symptoms, follow-up, and treatment changes
What comes back to the medical visit?
The referral may be outside the practice. The need is not.
Sleep. Anxiety. Depression. Medication questions. Pain. A patient still waiting for psychiatry.
When specialty care is delayed, what does the medical practice end up managing itself?
The referral problem may have a workforce answer.
Medical practices have patients whose mental health needs can be difficult to address through referral alone. At the same time, Michigan mental health practices report pressure on their ability to employ limited-license clinicians as reimbursement rules change.
Could some of that workforce help build mental health capacity inside medical care? We don’t know yet. That is one of the questions this study is designed to answer.
Figure 02
Could one workforce problem help solve another?
One side has the patients. The other side has the clinicians. Whether they can meet is the open question.
Medical practice
- Patients bring mental health needs
- Some are referred outside
- Practices report waits and gaps
Needs more mental health capacity
Mental health practice
- Employs limited-license clinicians
- Reimbursement pathways are changing
- Some respondents report reducing hiring
Has trained clinical capacity
Could integrated care connect them?
Medical provider + behavioral health care manager + psychiatric consultant
The integration study asks whether those pieces can actually fit, and what would have to change for them to fit safely, legally, clinically, and financially.
Why we’re asking.
In the Michigan Mental Health Counselors Association’s 2026 policy-impact survey of responding Michigan practice owners:
41%
reported already pausing hiring of limited-license clinicians.
45%
said they planned to employ fewer if the policy takes effect.
These percentages describe survey respondents, not all Michigan practices.
A billing change does not erase a clinician’s training. The question is whether some of that clinical capacity could appropriately move into integrated medical care.
Different roles
- MMHCA
- advocates around the current BCBSM policy.
- The Center
- studies what other structures may be workable.
- The Initiative
- carries relevant research into nonprofit policy and advocacy work.
Could a mental health clinician become the care manager?
Potentially. The role depends on the person and the arrangement.
Mental health clinicians may already bring useful skills: patient follow-up, brief interventions, symptom measurement, care coordination, and documentation. Whether a particular clinician can serve as a behavioral health care manager depends on qualifications, scope, supervision, employer arrangements, and payer rules.
The study asks whether practices could actually make that partnership work.
What Collaborative Care changes
Collaborative Care keeps more of the follow-up inside the medical team. A care manager stays in contact with the patient, a psychiatric consultant reviews the caseload, and the medical provider remains responsible for the medical care.
Medicare’s public guidance describes the model and its payment structure in MLN909432. Whether it works for one practice depends on staffing, patients, workflow, and payer rules. The Brief walks through those questions without assuming the answer is yes.
Need to apply the model to one practice?
The Brief explains the public model. State rules, licenses, payers, contracts, staffing, and rates determine what applies to one practice. Kedge Marketplace is the separate platform for that individualized work.
The exchange · about seven minutes
Seven minutes, if the Brief earned them.
We know what the payment model permits on paper. We do not yet know what Michigan practices could actually build. About seven minutes on what happens after your referrals, what your team handles itself, your access to psychiatric consultation, and whether hiring or partnering for mental health capacity could work in your practice helps answer that question.
Findings go to respondents first.
About 7 minutes
Referrals · wait times · unmet needs · psychiatric access · staffing · hiring or partnership · barriers to integration
The survey
The study is not collecting responses yet.
When it opens, the invitation you received will return you to this page. The guide above is complete and yours to use now.
At the end, three permissions are asked separately: whether we may follow up, whether we may quote you anonymously, and whether you want the findings. None is required. You will see any proposed quote before we use it.