Integrating all or some of the key elements of the Collaborative Care Model (CoCM) into primary care practice decreased suicide risk levels, attempts, and deaths, with reductions ranging from 25% to 56%, according to three “real-world” studies. The CoCM is a specific method for integrating treatment for many mental health and addiction disorders into primary care. The model uses a team-based approach that includes behavioral care managers (BCMs) and psychiatric consultants (clinical professionals with behavioral health training) who can prescribe medications.
With the CoCM, the BCMs and psychiatric consultants may or may not be co-located in a primary care setting. Unlike other integration models, CoCM requires medical provider organizations to incorporate measurement-based care, including systematic screening and registries.
The first of the three CoCM studies followed 3,809 individuals flagged as being “at risk” for suicide, and found that 56% experienced a reduction in suicide risk level. The study was by Concert Health, a behavioral health organization providing CoCM staff and other services to primary care clinicians in 52 provider organizations across 16 states.
The second of the three CoCM studies found that suicide risk decreased in 52% of consumers. Rates of depression and anxiety also declined. This study was by researchers from the Perelman School of Medicine at the University of Pennsylvania. It included 368 individuals “at risk” of suicide in 19 primary care practices across two states.
The third of the three studies, by Kaiser Permanente, found a 25% reduction in suicide attempts and deaths (combined) following implementation of certain key elements of CoCM in primary care across 19 practices in Washington. The study included 228,255 individuals receiving this intervention. Kaiser Permanente is now implementing all elements of CoCM.
The three studies were summarized in “Large Reductions In Suicide Risk, Attempts And Deaths Demonstrated By Three ‘Real World’ Studies in Primary Care,” by The Bowman Family Foundation (BFF). The report was released by Shatterproof and BFF with endorsements by the American Foundation for Suicide Prevention.
As a result of these findings, BFF recommended steps to generate broad-scale usage of the CoCM, including:
- For Medicaid: Enforce reimbursement equal to at least 100% to 130% of Medicare fee-for-service (FFS) reimbursement in all states.
- For employer and commercial plans: Set CoCM reimbursement at a level equal to at least 130% to 150% of Medicare FFS reimbursement and eliminate all consumer out-of-pocket expenses for CoCM.
- For payers: Allow the use of add-on code 99494 as frequently as justified by clinical need, and reimburse CoCM separately from, and in addition to, any care management fees, primary care capitation, or other global payments, as appropriate.
- For regulators and accreditation organizations: Allow in-network CoCM services to be counted as in-network mental health and addiction specialist services when assessing parity compliance and network adequacy, as appropriate.
- For provider organizations: Implement CoCM and consider utilizing CoCM service organizations for advice, training, billing support, consumer registries, and ongoing CoCM staff support.
The full text of “Large Reductions In Suicide Risk, Attempts And Deaths Demonstrated By Three ‘Real World’ Studies In Primary Care” was published April 7, 2025, by the Bowman Family Foundation. A free copy is available online at https://filesbff.org/CoCM_Suicide_Risk_Reduction.pdf (accessed April 17, 2025).
For more information, contact: Matt Bowman, Communications, The Bowman Family Foundation, 7234 Lancaster Pike, Suite 300, Hockessin, Delaware 19707-8743; 302-234-5750; Email: Matt.Bowman@TheBowmanFamilyFoundation.org; Website: https://thebowmanfamilyfoundation.org/
August 2025 00US25EUA0023