Models of Integrative Practice
Integrated care is provided by teams of experts from different fields including medicine, psychology, and nursing. There is a continuum between coordinated care, co-located care, and integrated care. Better integration improves outcome for more complicated patients, and the most complex patients require the highest levels of integration. There are several models of integrated care with demonstrated effectiveness in a variety of settings and studies. Integrated care models are poorly matched to the current system of reimbursement, and the short-term financial goals of decreasing expenses or maximizing profits have resulted in greater expenses later as these patients get more complex and have increased morbidity. The lack of integrated care has made these patients extremely costly, and the health system is responding to them by suggesting that they, rather than the conditions they are afflicted with, are the problem. While there is good evidence that these patients can be treated in a cost-effective manner, the current financial organization of medical care makes it difficult to initiate and sustain cost-effective care and is a major barrier to the provision of integrated medical care.
KeywordsIntegrated care Medical team Formulation Co-located care Coordinated care Pay-for-performance Behavioral health Financial barriers Reverse co-location
- 1.Heath B, Wise-Romero P, Reynolds K. A review and proposed standards framework for levels of integrated healthcare. Washington, D. C.: SAMHSA-HRSA Center for Integrated Health Solutions; 2013. Retrieved October 2018 from http://www.integration.samhsa.gov/integrated-care-models/A_Standard_Framework_for_Levels_of_Integrated_Healthcare.pdfGoogle Scholar