CoCM Staffing Models: In-House vs Outsourced
CoCM Staffing Models: In-House vs Outsourced
One of the biggest factors for practices considering implementing a new Collaborative Care Model (CoCM) program is how to staff it. Do you develop an internal CoCM team or do you partner with an outsourced CoCM staffing organization?
Background
The Collaborative Care Model (CoCM) is an evidence-based Integrated Behavioral Health (IBH) clinical model, with its own set of CMS billing codes, designed to increase access to behavioral health support and improve patient outcomes.
It’s a specific model of integrated care, involving a PCP, care manager, and a psych consultant.
A major factor organizations need to consider when implementing CoCM is how to staff it. Organizations often either:
Utilize existing staff or hire new staff to manage in-house
Outsource the care manager and / or psych consultant via a staffing partner
At Mirah, we work with healthcare systems and medical groups on both paths. It’s rarely a "one size fits all" answer and usually comes down to your existing infrastructure and how fast you want to scale. What matters is understanding the tradeoffs so you can choose the the approach that fits your clinical goals, financial model, and capacity today.
What CoCM Staffing Really Requires
Before comparing models, it helps to level set on what a CoCM program requires to operate effectively.
A successful CoCM program includes:
Well-trained care managers who excel at patient outreach and systematic follow-up
As the crux of the CoCM model, these individuals must be disciplined in time-tracking and registry management
A psych consultant familiar with CoCM and comfortable providing weekly caseload reviews and treatment recommendations
Oversight of revenue, budgets, productivity, and employee performance
Measurement-based care (MBC) informed care pathways
Optimized workflows for registry management, billing, documentation, and compliance
Clinical oversight
Ongoing training and performance management
Staffing is not just about filling roles. It is about building a system that can consistently deliver effective results both clinically and financially.
In-House CoCM Staffing
An in-house staffing model is when the practice either:
utilizes internal staff to fill the required roles of CoCM
hires new staff to fill the required roles of CoCM
Under both circumstances, you’re managing the staff yourself, as opposed to outsourcing it.
Pros of In-House Staffing
Direct control over your team
You fully own hiring decisions, training priorities, and day to day management. For organizations with strong internal leadership and experience in behavioral health operations, this can be appealing.
Deeper integration with your practice culture
In-house staff are embedded in your workflows, budgets, and team hierarchy, and often feel more connected to the broader organization.
Direct Control Over Economics
By developing an in-house CoCM team, you avoid sharing the economics with an outsourced partner.
Cons of In-House Staffing
Longer time to launch
Hiring care managers and psych consultants can take time, especially in competitive labor markets. It’s important to hire a full-time care manager dedicated to the CoCM program.
Higher operational burden
Training, supervision, coverage planning, and turnover all fall on your internal team. For the first few months, new care managers may require additional guidance and / or supervision with regards to the administrative and clinical aspects of their role. Planning for clinical supervision / mentorship is important, as it can be costly and interrupt operations to use practicing physicians to fill this supervisory role.
Risk during ramp up
Early inefficiencies can significantly impact both care quality and reimbursement if workflows are not well-established in from day one.
In-house staffing works best for organizations with existing behavioral health infrastructure, strong clinical leadership, and the patience to build over time.
By working with Mirah, we give you the playbook to ensure your program is set up for long-term success from the beginning
Outsourced CoCM Staffing
An outsourced CoCM staffing model partners your practice with a staffing organization that supplies everything needed for a CoCM program( care managers, psych consultants, a registry). These staffing partners are capable of providing a turnkey experience, staffing and managing your CoCM program in its entirety.
Pros of Outsourced Staffing
Faster implementation
Outsourced teams are typically trained in CoCM and ready to deploy, allowing practices to launch in days instead of weeks.
Operational and clinical expertise baked in
Staffing partners bring established workflows, supervision models, and performance benchmarks.
Reduced hiring and management burden
Your practice avoids the complexity of recruiting, onboarding, and ongoing staff management.
Predictable costs
Staffing fees are often structured to align with patient volume, which can reduce financial risk early on.
Cons of Outsourced Staffing
Less direct control
While strong partners integrate closely, outsourced staff are not your employees. By utilizing an outsourced staffing partner, you give up most of your control over the program.
Variable quality across vendors
Not all staffing partners are equal. Experience with CoCM, measurement-based care (MBC), and payer requirements varies widely.
Outsourced staffing is often ideal for primary care practices, smaller health systems, and organizations that want to move quickly without building internal infrastructure or fronting the startup costs of a CoCM program.
At Mirah, we have a variety of highly experienced staffing partners working in different settings across the country (obgyn, pediatrics, oncology, family medicine, women’s health, etc.).
How Mirah Fits In
Whether you choose an in-house or outsourced staffing model, Mirah is designed to support both.
For in-house teams, Mirah provides a robust CoCM optimization registry, the CoCM success playbook, clinical workflow support, measurement based care tools (500+ clinically validated assessments), and billing optimization tools needed to scale efficiently and stay compliant.
For outsourced models, Mirah acts as the connective tissue between your practice and your staffing partner. Our staffing partners use Mirah’s CoCM optimization registry, and provide everything needed for a turnkey CoCM solution, all fully aligned with CMS requirements.
Whether you’re debating in-house staffing or interested in a turnkey CoCM solution, we’re your ultimate success partner. Our goal is simple. Ensure everyone, regardless of size and resources, can successfully launch and scale an effective, revenue generating CoCM program.
Choosing the Right Model for Your Practice
When deciding between in-house and outsourced CoCM staffing, consider:
How quickly you need to launch
Your internal capacity to hire and manage behavioral health staff
Patient volume and growth expectations
Your tolerance for operational risk during ramp up
Many practices even evolve over time, starting with outsourced staffing and transitioning to in-house teams as programs mature.
There is no wrong choice. The only wrong choice is not starting somewhere.
