Designing Payment for Collaborative Depression Care Management in Primary Care. Yuhua Bao, Ph.D. Assistant Professor Division of Health Policy, Department of Public Health Weill Cornell Medical College. Acknowledgement.
Yuhua Bao, Ph.D.
Division of Health Policy, Department of Public Health
Weill Cornell Medical College
This work is supported by grants from the National Institute of Mental Health (K01 MH090087, P30 MH085943). The IMPACT study was funded by grants from the John A. Hartford Foundation and the California Healthcare Foundation.
I thank the following individuals contributed to the work or provided helpful discussion:
Martha Bruce, PhD, MPH,Lawrence Casalino, MD, PhD, Susan Ettner, Ph.D., Heather Gold, PhD, Andrew Ryan, PhD, Bruce Schackman, PhD, Leif Solberg, M.D, Jürgen Unützer, MD, MPH
1 or more yrs
Kupfer DJ. J Clin Psychiatry. 52(5s):28-34,1991.
STEP 1 Clinical Model
Antidepressant or psychotherapy (if preferred)
Reassessment by care manager and discussion with PCP; Psychiatric consultation if needed.
Monthly contact w/ care manager
Switch to (or augmentation with) other antidepressant or psychotherapy
Reassessment by care manager and discussion with PCP; Psychiatric consultation if needed
Combination of antidepressant and psychotherapy; Consider referral to specialty MH services
Adapted from Unutzer et al. (2001)
Monthly contact w/ care manager to maintain therapeutic gains
Bundled Case Rate
What should be adjusted, what should not?
length of stay in DCM (1, 2, …, 12 mos),
baseline severity x months
month indicator (2nd, 3rd, …, 12th mo.),
tx response/remission at beginning of month,
bl severity x month indicator,
tx response/remission x month indicator
BL severity did not predict monthly DCM intensity statistically and was not shown in this graph.