CoCM facilitates behavioral health management at scale

CoCM is a structured approach to integrating behavioral health into primary care. It virtually or directly embeds a licensed behavioral health provider, such as a licensed clinical social worker or psychologist, within a primary care (or sometimes specialty care) office as a care manager. This enables real-time collaboration and coordinated treatment for low-acuity behavioral health conditions like depression or anxiety. The setup allows providers to address behavioral health needs during routine medical visits, reducing delays in care and improving continuity. This is especially important for patients with medical and behavioral comorbidities. In the event the primary care-based team identifies a higher-acuity behavioral health need, the primary care provider (PCP) can consult or provide a warm handoff to a consulting psychiatrist.

CoCM delivers measurable benefits across systems

Despite its proven impact, CoCM remains underutilized, often due to persistent misconceptions about its cost, complexity, and clinical burden.

These savings translate to $1,600 to $2,400 per patient annually, depending on payer type.⁴ The reductions stem from lower utilization of high-cost psychiatric services, including a 9% drop in inpatient psychiatric admissions and a 15% decrease in psychiatric professional visits per 1,000 patients per year, for patients who receive care delivered through CoCM.⁴

Similarly, evolvedMD’s CoCM program reduced costs for patients with comorbid chronic conditions. Patients with cardiovascular disease or diabetes who received care from evolvedMD experienced 16% and 18% lower risk-adjusted total cost of care, respectively, compared to those treated by other models.⁴

Once the hurdles of initial implementation are addressed, CoCM programs become self-sustaining, making them both effective and financially viable in the long term.

Myth #3: This will create even more work for PCPs and drive burnout

Primary care providers already help manage their patients’ diagnosed or undiagnosed behavioral health conditions. This model offers them professional support to ensure care delivery is happening at top of license. Primary care visits often include behavioral health screening. In the event of a positive screen, PCPs find themselves in the position of either taking on the care themselves — which data suggest they do not necessarily feel confident doing — or referring their patient out, with little control or visibility into follow-up care.

A survey of over 700 PCPs, conducted before introducing CoCM for patients with depression and chronic conditions, found that 72% believed the model would be “very helpful” for treating complex patients.⁶ Those experiencing burnout were significantly less satisfied with their ability to manage behavioral health needs and reported lower career satisfaction.⁶

CoCM helps alleviate provider burnout by distributing the workload and improving access to behavioral health expertise. Providers are often able to retain patient care within their office and care team without having to take on the behavioral healthcare themselves. When their patients need higher-level care, it is a matter of warm handoff.

Myth #4: It’s too complex for our system to implement

While CoCM requires upfront planning and infrastructure, its design fits within existing primary care workflows. By embedding behavioral healthcare managers directly into clinics, CoCM enables real-time collaboration and care coordination. This approach replaces fragmented referrals with immediate support and longitudinal follow-up, leading to better access and continuity of care.

Case in brief: How Tampa General Hospital implemented CoCM in primary care

Challenge

Tampa General Hospital identified a persistent gap in behavioral healthcare: Patients with low-acuity behavioral health needs were not receiving timely, coordinated support. The traditional referral process often left them with long wait times to see behavioral health specialists, their insurance was often denied when seeking care, and many individuals abandoned care as a result. This lack of coordination meant manageable issues were at risk of escalating into acute crises, impacting patients’ lives, families, and work.

Approach

In October 2024, Tampa General partnered with evolvedMD to embed behavioral health care managers directly within 20 primary care clinics. Instead of a quick screening and referral slip, patients now receive immediate, longitudinal support from an embedded care coordination team with evolvedMD. This team works shoulder-to-shoulder with Tampa General’s primary care providers, ensuring that patients are not only assessed but also actively connected to appropriate behavioral health resources. Patient engagement and outcomes are tracked over time.

Outcomes

Tampa General reports improved care coordination and more efficient access to behavioral health services. They also report strong enthusiasm among participating PCPs and their teams for expanding the model to additional clinics and specialties.

You don’t have to implement CoCM alone

Launching CoCM requires operational infrastructure, behavioral health expertise, and a clear strategy for scale. Some providers have developed this in-house, but many struggle to build this on their own, especially when primary care teams are already stretched thin, and executive bandwidth is focused on fighting fires.

That’s why partnership has become a common path forward. Working with a specialized CoCM provider allows systems to move faster, maintain fidelity to the model, and avoid common pitfalls to implementation. These partners may bring the staffing, training, and/or billing support needed to make the model sustainable.

Partnership also helps address access challenges. CoCM increases primary care touchpoints that can strain systems with limited capacity. A CoCM partner organization can “own” the visit, delivering behavioral health services within the PCP setting without adding burden to the provider.

Based on his own experience, and the success Tampa General has seen with the model, Couris recommends that health systems interested in pursuing CoCM follow these steps:

1. Assess strategic fits and gaps: Evaluate behavioral health needs and internal capabilities. Identify where external expertise could accelerate progress.
2. Choose the right partner: Select a partner whose model complements your system’s goals and fills critical gaps in staffing, training, and billing.
3. Leverage external support for implementation: Use your partner’s infrastructure to maintain fidelity to the CoCM model while scaling efficiently across care settings.
4. Track outcomes and iterate: Monitor key performance indicators such as access, coordination, and provider workflow. Use data to refine and sustain the model.

What’s next for provider leaders

In anticipation of market forces exacerbating already razor-thin margins, many providers are looking at rationalizing services — and unfortunately, behavioral health services are among the first considered for reduction. Rationalizing behavioral health services may provide upfront financial relief for certain organizations. However, unmanaged behavioral health conditions lead to higher medical spend for patients with comorbid conditions and ultimately strain our healthcare infrastructure by placing the care burden on a system that likely isn’t prepared to carry it. Systems are looking for financial and operational lifelines to keep behavioral services up and running without taking away from their bottom line. CoCM can help.

If your organization is exploring ways to strengthen behavioral health integration, start by reviewing the latest research on behavioral health. Our curated library includes strategic playbooks, expert insights from industry leaders, implementation case studies, and performance benchmarks to help you assess readiness, guide change management, and advance toward sustainable behavioral health systems.

To learn more about how partnership can accelerate CoCM deployment, contact evolvedMD. Their team works with health systems across the country to launch and sustain high-impact CoCM programs whether you're just getting started or looking to scale.

Launched in 2017, evolvedMD is a leading provider of integrated behavioral health services in primary care. evolvedMD’s unique model places behavioral health specialists onsite within a primary care practice, offering an economically viable and better way to integrate behavioral health that drives improved patient outcomes.

evolvedMD is a four-time Inc. 5000 fastest-growing company in America.

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This article is sponsored by evolvedMD, an Advisory Board member organization. Representatives of evolvedMD helped select the topics and issues addressed. Advisory Board experts wrote the content, maintained final editorial approval, and conducted the underlying research independently and objectively. Advisory Board does not endorse any company, organization, product or brand mentioned herein.

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Advisory Board experts conducted the research and maintained final editorial approval.