Table 1. Fletcher Allen Health Care Collaborative Care Model
  • Full-time primary care behavioral health clinician with clinical and care management responsibilities

  • Clinician availability for warm handoff and consultation

  • Brief evidence-supported treatment

  • Intensive training of behavioral health collaborative care clinician in the model, including treatment protocols for a broad range of psychological and medical problems amenable to behavioral health treatment

  • Population (panel)-based care using measurement-based stepped treatment and other resource availability

  • Practice re-engineering of operational processes, including “warm handoffs” (personal introductions of behavioral clinician to patient by primary care physician)

  • Automated referral and patient scheduling

  • Training physicians and staff in behavioral care procedures

  • Appointment frequency and interval consistent with primary care

  • Shared electronic health record with mental health note availability

  • Care management coordinates referrals and information out to specialty care if greater intensity of care is needed; management of external information

  • Brief interventions during brief time frames

  • Coordination of services and finances to optimize sustainability

  • Regular reports of performance, relative value unit, and financial data