Integrated care in the real world.

This presentation describes a project by the CTN community treatment program ADAPT, Inc. aiming to develop an integrated care model situated in free-standing, primary care private practices in Rosewood, OR. Barriers to integrated care are discussed, including lack of time or skills, attitudes about substance use disorder and mental health, HIPAA requirements, billing, and sustainability. After implementation, over 2,000 patients were being screened a year (20% of total annual patients), and treatment was provided to about 15%. Sixty-four percent showed significant improvement, and overall medical utilization by Medicaid patients decreased by 13%. For “frequent flyer” Medicaid patients, medical utilization decreased by 33%. This model appears to be effective in reducing costs and improving care for patients.