Intervention Minutes (and Why They Matter)

There are four overarching goals that, together, create a successful Collaborative Care Model (CoCM) program:

  1. Increasing access to care

  2. Improving clinical outcomes

  3. Achieving financial sustainability

  4. Increasing provider satisfaction

In order to achieve all of these goals, care managers are tasked with ensuring that patients receive the right amount of care at the right time. If patients do not receive enough care, they might not get better. On the other hand, if a care manager spends too much time with just one patient, their ability to meet the needs of other patients will be limited. 

Care managers can think of minutes as corresponding to the “dosage” of treatment that a patient is receiving each month. Care managers should focus on providing the correct amount of care to patients based on their individual needs and their phase of treatment.

For example, patients tend to require more attention and time in the first one to two months of treatment, as compared to subsequent months. Early in treatment, patients engage more successfully if they have brief, frequent contacts with their care manager.  As patients begin to make improvement and build their self-management skills, however, they can benefit from decreased contact. This “tapering down” of care allows patients to practice their skills and prepare for a successful discharge from the program. 

Finally, minutes per month are directly tied to the billing requirements for CoCM. Accurately tracking time allows care managers to get “credit” for the work they are doing, which ensures financial sustainability of the program.

BELOW MINUTES

For example, if a patient is below minutes, the care manager may:

  • seek input from a supervisor/clinician regarding other interventions that may benefit the patient

  • consider if the patient is ready to prepare for discharge

ABOVE MINUTES

On the other hand, if a patient is above minutes, the care manager may want to:

  • Consider a change in care plan to support the patient more efficiently

  • Consider whether the patient would benefit from a higher level of care, such as specialty behavioral health care

In any case where the patient has a pattern of minutes above or below the target range for two or more months in a row, the care manager should bring the case to psychiatric case consultation for review and discussion.

Please note:
In the beginning of a collaborative care program, it is not uncommon for PCPs to get excited and refer patients that need the most help. This may require spending a lot of time giving the patients the adequate care necessary. This is sometimes referred to as the “severity trap.”

If this is the majority of your caseload as a care manager, it may be hard to manage and could lead to care manager burn out. Being mindful of the minutes spent on patient care facilitates better patient outcomes and can also help prevent burn out.