TY - JOUR
KW - Capitation Fee
KW - Case Management/economics
KW - Chronic Disease
KW - Depressive Disorder, Major/economics/therapy
KW - Fee-for-Service Plans
KW - Humans
KW - Insurance, Health, Reimbursement
KW - Insurance, Psychiatric/classification
KW - Mental Health Services/economics/organization & administration
KW - Pilot Projects
KW - Primary Health Care/economics
KW - Social Support
KW - United States
AU - J. Bachman
AU - H. A. Pincus
AU - J. K. Houtsinger
AU - J. Unutzer
A1 - 
AB - OBJECTIVE: Inconsistent third-party reimbursement for depression care management is a significant economic barrier to the utilization and sustainability of the chronic illness care model in primary care practice settings. We review common mechanisms used to procure payment for depression care management services, discuss obstacles encountered and suggest future directions. METHOD: We describe several extant models for funding depression care management services in use at the demonstration sites of the Robert Wood Johnson Foundation funded "Depression in Primary Care" project and similar programs. We derived this information from ongoing discussions with the sites' project directors and through an extensive electronic literature search on "care management, funding mechanisms and depression." RESULTS: Funding mechanisms include (a) practice-based care management on a fee-for-service basis, (b) practice-based care management under contract to health plans, (c) global capitation, (d) flexible infrastructure support for chronic care management, (e) health-plan-based care management, (f) third-party-based care management under contract to health plans and (g) hybrid models. CONCLUSIONS: While substantial obstacles remain in the way of fully implementing these depression care management funding mechanisms (e.g., variations in care managers' credentials and work locations and third-party payer concerns about overutilization and transaction costs), several recent policy advances provide some optimism for the potential adoption of financial mechanisms to support and disseminate these evidence-based practices.
BT - General hospital psychiatry
C5 - Financing & Sustainability;Healthcare Policy
CP - 4
CY - United States
DO - 10.1016/j.genhosppsych.2006.03.006
IS - 4
JF - General hospital psychiatry
N2 - OBJECTIVE: Inconsistent third-party reimbursement for depression care management is a significant economic barrier to the utilization and sustainability of the chronic illness care model in primary care practice settings. We review common mechanisms used to procure payment for depression care management services, discuss obstacles encountered and suggest future directions. METHOD: We describe several extant models for funding depression care management services in use at the demonstration sites of the Robert Wood Johnson Foundation funded "Depression in Primary Care" project and similar programs. We derived this information from ongoing discussions with the sites' project directors and through an extensive electronic literature search on "care management, funding mechanisms and depression." RESULTS: Funding mechanisms include (a) practice-based care management on a fee-for-service basis, (b) practice-based care management under contract to health plans, (c) global capitation, (d) flexible infrastructure support for chronic care management, (e) health-plan-based care management, (f) third-party-based care management under contract to health plans and (g) hybrid models. CONCLUSIONS: While substantial obstacles remain in the way of fully implementing these depression care management funding mechanisms (e.g., variations in care managers' credentials and work locations and third-party payer concerns about overutilization and transaction costs), several recent policy advances provide some optimism for the potential adoption of financial mechanisms to support and disseminate these evidence-based practices.
PP - United States
PY - 2006
SN - 0163-8343; 0163-8343
SP - 278
EP - 288
EP - 
T1 - Funding mechanisms for depression care management: Opportunities and challenges
T2 - General hospital psychiatry
TI - Funding mechanisms for depression care management: Opportunities and challenges
U1 - Financing & Sustainability;Healthcare Policy
U2 - 16814626
U3 - 10.1016/j.genhosppsych.2006.03.006
VL - 28
VO - 0163-8343; 0163-8343
Y1 - 2006
ER -