Lumigrate's Collaborative Care Model

Lumigrate's seminars and products are intended to help you become the most knowledgeable person in the position in the center of your health care team, and feel empowered as the "manager". This might be a new concept to some, or an existing concept to others. You might have been doing this and not really realized it! Lighting your path to health and well being.

In the United States, health care has blossomed in the 200+ years our nation has existed. The Native American Indians had medical practitioners, and with the influx of people from Europe and the scientific discoveries being made in the Western world, medical treatment evolved and developed into an industry that came to rely heavily on insurance companies.

It is important to realize that doctors, hospitals and insurance companies are businesses which work together for their common clients. Insurance companies reimburse only for practitioners and modalities they believe are appropriate to pay for:  medical doctors (MDs) and osteopathic doctors (DO) and their extensions (nurse practitioners, physicians assistants) and those they prescribed referrals to (physical, occupational and speech therapy, for instance). As other professionals lobbied and the patients and their employers who provided medical benefits requested, other services began to sometimes be reimbursed, such as chiropractic and acupuncture.

Both the medical providers and the insurance companies have operated under what is called the 'allopathic medical model'. The word 'pathogen' became the center of scientific thinking with medicine in the modern medical era, and much advancement was made with the advent of understanding bacteria and viruses and other causes of disease, and our medical system grew to be based on this 'model' of thinking and treating and billing.  Due to the overwhelming advances, it has become a very big task to have codes and systems for charging for services.  As more and more people were appropriate for treatments with modern medicine and more medications were available, health care costs went up, and as most of us are aware, medical professionals generally had to spend less time with each patient. Sometimes specific treatments were no longer covered. It has been a constantly changing business, and it continues to change every day.

By now, most everyone is aware and likely concerned with the state of the health care system due to these changes. Providers often feel frenzied, patients sometimes feel they have fallen in a crack, and an incredible amount of resources go into the billing and revenue collections piece of the medical businesses, which eventually leads to the providers having to see more patients in order to generate enough revenue to pay for everything... the proverbial 'vicious cycle'.

But when medical professionals are not linked into billing health insurance companies for the services they provide to patients, it changes how the health care providers and patients can interact. Since insurance companies do not reimburse providers for their time charting or communicating about patients to other providers, they are not inclined to spend more time than absolutely necessary on communication.  The 'Collaborative Care Model' is another model which has been in existence and has been proven to increase financial efficiency and patient satisfaction in many organizations which have utilized it.

The Integrative Medicine Center of Western Colorado (IMC) chose to follow this model and to charge patients for the treatment they receive directly, and not engage in filing charges to insurance companies. Many people today either have high deductive insurance and can turn their receipts in to their insurance if it will reimburse for the services, or they do not have insurance and are paying directly out of pocket. Others recognize the value of being a patient of 'The IMC' in addition to being a patient at other practices which do file insurance.

The team meets on a regular basis to talk about diagnosis and cases, allowing the vast array of specialists to share their insights and knowledge, which results in the patients getting more thorough input from their provider and efficient referrals to other providers if appropriate.  Due to the collaboration between providers, the patients sense they are in the center of a robust and complimentary health care team.  (Please refer to the figure above).

Chris Young, Ph.D., a psychologist consulting with the IMC, has studied medical models and experienced both the collaborative care model during training in the U.S. military and the western allopathic model as an owner of a large behavioral health practice in Grand Junction.  Dr. Young presented "Health Management: Paradigms for Health Care" at the IMC this summer, of which you can view a segment by clicking here.

Lumigrate hopes this has been helpful to you, and invite you to offer your feedback and requests by choosing the Contact link at the top of this website.