Depression care management: impact of implementation on health system costs

This study examined the mental health care costs associated with implementation of a collaborative care management (CCM) of treatment for depression in primary care. A retrospective review of all costs was performed over a 2-year period associated with providing care to adult patients at clinical sites with CCM versus those with usual care, comparing total and mental health per member per month (PMPM) costs for 2008 and 2009 (patient population = 103,000). The mental health-PMPM costs as a percentage of total health care costs at the clinic without CCM were 4.65% in 2008 and 4.5% in 2009 (p = .085). In the clinics with CCM, there was a significant difference between the 2 years with a decrease noted in 2009 of 4.91% compared with 4.36% in 2008 (p < .0001). This study demonstrated that, on a population basis with the implementation of CCM, the metric of mental health-PMPM (using the actual costs of delivering care) suggested that an increased short-term cost of care is not always realized. Collaborative care management treatment for depression may be a more cost-efficient method of care for the population as a whole, even in the short term.