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Sustainable Lifelines: Supporting Integrated Behavioral Health Services for Children and Adolescents in the Accountable Care Era

Objectives: Debundled payment mechanisms, such as those proposed to be used in the accountable care organization (ACO) structure, have the potential to promote integrated behavioral health and general medical care, notably by supporting services such as collaborative care that are not routinely available or covered under traditional fee-for-service. However, to date, bundled payment mechanisms have only been applied to adult populations. We present current efforts to develop a reimbursement model to provide behavioral healthcare for children and adolescents who are primarily seen in primary care settings with limited access to psychiatrists. The Michigan Child Collaborative Care (MC3) program has components similar to many other state-based initiatives that are designed to increase access to behavioral healthcare, notably through telepsychiatry, but adds components of the evidence-based Collaborative Care Model (CCM) to promote sustainability through enhancing the capacity of primary care physicians to provide behavioral health treatment on-site.