Press Release
Why Collaborative Care IS the Path Forward – an AJMC podcast with Giuliana Grassi and Anna Bobb
Jul 01, 2025 - 9:17am
Anna Bobb, executive director of the Path Forward Coalition, recently joined Managed Carecast—a podcast from the American Journal of Managed Care—for a conversation with AJMC editor Giuliana Grassi about one of the most promising solutions for expanding access to mental health care: the Collaborative Care Model.
In the interview, Bobb describes how the evidence-based model brings mental health services directly into primary care through a coordinated team that supports patients earlier and more effectively. The discussion explores why the model has gained momentum nationwide, the barriers that still limit its reach, and the policy and payment changes needed to bring Collaborative Care to the millions of Americans who could benefit.
Listen to key moments from the conversation below, or read an edited transcript of the discussion.
Editor’s note: The transcript below has been lightly edited for clarity and length.
🎧 Clip: Collaborative Care Model Overview
AJMC: Can you share a brief overview of the Collaborative Care Model and why it’s considered the gold standard in integrating mental health care into primary care?
Anna Bobb: The Collaborative Care Model, first and foremost, is a team-based approach to care. It’s proven and highly effective in treating mild and moderate behavioral health conditions, conditions like depression, anxiety, substance use disorder, ADHD.
The Collaborative Care Model is an alternative to traditional care. In traditional care, mental health care and physical care is provided separately. So when a patient goes to their primary care doctor or their pediatrician’s office and a mental health issue is identified, often what will happen is, after the visit, they’re stuck because they face long wait times, they can’t find a mental health provider.
What happens in collaborative care is that a whole new person is added to the care team. This person is the behavioral health care coordinator, and the job of this person is to put the patient at the center of care.
Some of the things that this person does is they work closely with the patient, they help the patient overcome barriers that they may face, barriers like scheduling. They help with medication adherence. They help potentially with some problem solving or counseling.
This person transforms the experience for the patient, and they also do help the doctors quite a bit. So much so, in fact, that the time of the psychiatrist in this model is leveraged eight times over, according to one of the studies that our partners at the Mental Health Institute did.
Why is collaborative care the gold standard? It’s the gold standard because it has hands down amazing results. Time to remission from depression is improved sevenfold. It’s validated by some hundred clinical studies and meta analyses. It’s been shown to work with every manner of patient — older patients, pregnant women, younger patients, underserved patients, rural patients. It’s been validated with all of those different kinds of patients, and it works for all of them.
🎧 Clip: Changing Attitudes Toward Mental Health and Care Delivery
AJMC: I know the recent Milliman report shows a tenfold increase in the use of the Collaborative Care Model in commercial insurance. What does that growth tell us about changing attitudes towards mental health and care delivery?
Anna Bobb: We think that this is just a striking result and a signal that mental health treatment and care is now being fully embraced by the mainstream medical system.
It’s a huge endorsement that all four payers are now paying for this kind of care, and that we’ve seen dramatic increases across all of those payers.
Mental health has been called the invisible crisis for so long, but now I think it’s finally very visible to people. And I think that’s what the results show.
🎧 Clip: Barriers to Care
AJMC: Even with that growth, the report notes that only 100,000 commercially insured people accessed Collaborative Care Model services in 2023, which is less than 1% of those who could benefit. What are the most significant barriers to broader adoption from your perspective?
Anna Bobb: There are some initial startup costs associated with implementing the model, and we think those are some of the barriers.
Health systems have hard costs associated with the model. They have to retool their staffing and billing, and people have to work together in a totally different way in this team-based model.
What we’ve found is that physician champions are one of the biggest ways to overcome these barriers. We’ve also seen philanthropy play an important role—support from philanthropists can help local clinics and health providers overcome those startup costs. That’s another great way to overcome those barriers.
🎧 Clip: The COMPLETE Care Act
AJMC: Path Forward is backing the COMPLETE Care Act to expand Medicare reimbursement for the Collaborative Care Model. How would this legislation move the needle, particularly for primary care practices that are hesitant to adopt the model due to the startup costs you mentioned?
Anna Bobb: The sort of rule in medicine is what is paid for is what will be provided. If we pay generously for the care that works, we’re going to see more of that care, and then the outcomes will follow.
The outcomes on suicide, overdose, and mental health will follow us providing the right care.
If the COMPLETE Care Act is enacted, what I think we would see is mental health screenings in Medicare being as common as screening for blood pressure or heart disease, at a time that we’re facing this huge mental health crisis.
The bill would give primary care doctors new resources, staff support. It would improve quality, improve treatment costs, increase care coordination, so it would have profound changes in the primary care setting.
Specifically, and in a more technical sense, what the Medicare bill does is that the COMPLETE Care Act would give practices some breathing room because it would raise the rate for collaborative care and allow practices the chance to adopt the model in that time.
🎧 Clip: The CoCM National Heat Map
AJMC: Path Forward also released a national heat map alongside the report showing where the model is being used. What do you hope providers, payers, and policymakers take away from this tool?
Anna Bobb: We know collaborative care works, but we really need to accelerate that uptake so we can save more lives and help more people.
By our estimates, 60 million Americans could benefit from collaborative care — adults and children. As you mentioned, only a fraction are getting it right now.
What we believe and what we’ve shown with our research is that if collaborative care was available everywhere, 14,000 lives could be saved from suicide.
We know that more than 80% of people who died from suicide received healthcare in the year prior, most commonly with their primary care doctor.
If we had collaborative care, people would be getting relief and healing sooner.
The bottom line is we really do have to act now. Primary care doctors can champion this model in their clinics. Payers should pay generously for this model, whether you’re a public payer or a commercial payer.
Policymakers can activate the Medicaid codes. We have Medicaid codes in 34 states, but we know that 16 remain and need those codes. Policymakers can also support the COMPLETE Care Act so that we get uptake in Medicare.
🎧 Clip: How Can Employers Help?
AJMC: How can employers, especially those offering commercial insurance, play a role in pushing for more widespread access to the Collaborative Care Model?
Anna Bobb: That’s a really important question. We’re the only mental health group that actually has employers at the table, and it’s really critical because half of the country has employer-sponsored insurance, so they have a very big role to play.
Our partner, the National Alliance of Healthcare Purchaser Coalitions, works with employer coalitions around the country on this issue, educating them.
Employers, through their purchasing power, can advance collaborative care because they influence insurers through their contracts. They can influence insurers to make sure collaborative care is paid for generously so that everyone who can benefit will get access to this important care.
🎧 Clip: Policymakers + Payers
AJMC: What message would you give policymakers and payers about the urgency of scaling up the Collaborative Care Model, especially in light of ongoing crises like suicide rates and the opioid epidemic?
Anna Bobb: We have to start with the fundamental. We know that half of people who need mental health care are not getting access to that care.
People face scarcity, they face wait lists, and they face high costs associated with mental health care.
We have to get ahead of the suicide and opioid crises, and that’s all about intervening earlier.
We have to find people where they are, and where they are is in primary care.
It’s one of the best places to identify people. It’s where most mental health issues and psychotropic drugs are prescribed, and where most mental health issues are detected.
There is currently a ten-year delay between the time a person establishes symptoms of onset and when they get a diagnosis of a mental health condition.
We’ve got to cut that time. That’s what collaborative care does.
We have to do better than that, and we know that intervention through collaborative care saves lives and heals people. So we need more of it.
🎧 Clip: Network Adequacy
AJMC: There has been discussion about mental health parity and substance use parity, and challenges with enforcement after a recent rule was halted. Could you share any insight on how the Collaborative Care Model and its adoption might address some of that?
Anna Bobb: Getting more care that works and providing care solutions that we know are effective is actually a way of delivering on the promise of parity.
It’s a way that the healthcare system can step up and deliver on that promise through a smarter approach to getting people the care that they need.
One of the things that the study, the Milliman report, and the map shows is that there are champions all over the country who are carrying the torch for collaborative care.
We have to be grateful that there are so many dedicated providers who are committed to this work, because they’re really, at the end of the day, the people who are carrying this banner forward.
Listen to the entire podcast here.