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Realigning economic incentives for depression care at UCSF
Mitchell D Feldman1, Michael K Ong, Deborah L Lee
1University of California, San Francisco, CA 94143-0320, USA.
Administration and Policy in Mental Health
|October 11, 2005
Summary
Financial incentives are crucial for primary care providers (PCPs) to treat depression. However, longer appointment times did not motivate PCPs, suggesting a need for broader collaboration for sustainable behavioral health integration.
Area of Science:
- Health Services Research
- Primary Care Medicine
- Behavioral Health Integration
Background:
- Behavioral health carve-out models create financial barriers for primary care providers (PCPs) treating depression.
- Integrating behavioral health into primary care is essential for improving patient outcomes.
Purpose of the Study:
- To describe a novel collaborative model between a primary care practice, health insurer, and managed behavioral health organization (MBHO).
- To evaluate the early impact of financial and time incentives on PCP engagement in treating depression.
Main Methods:
- A collaborative arrangement was established involving a primary care practice, insurer, and MBHO.
- PCPs were offered financial reimbursement and extended appointment times for treating depressed patients.
Main Results:
- Financial incentives proved critical for the implementation of the collaborative model.
- Time incentives (longer appointments) did not significantly motivate PCPs to increase depression care.
- Early findings highlight the importance of financial structures in facilitating integrated care.
Conclusions:
- Financial incentives are a key driver for PCPs participating in integrated behavioral health models.
- Sustainability requires multi-stakeholder involvement, including multiple practices, insurers, and MBHOs.
- Future models should focus on optimizing financial reimbursement rather than solely relying on time-based incentives.