Email UpdatesLiterature Collection
Collection Insights
11K+
References
9K+
Articles
1400+
Grey Literature
4600+
Opioids & SU
The Literature Collection contains over 11,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
11202 Results
2601
Cost of Practice Transformation in Primary Care: Joining an Accountable Care Organization
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: The purpose of this study is to examine the costs related to practice transformation from the perspective of primary care organizations transitioning to become participants in Accountable Care Organizations (ACOs). We pose two research questions: 1) Will a Rural Health Clinic that participates in an Accountable Care Organization see higher or lower cost per visit, and 2) If the cost per visit is higher or lower, how large will that difference be? We analyze administrative data from a panel of over 800 Rural Health Clinics for the period 2007 - 2013 using a treatment effects approach, where a clinic's participation in an ACO is viewed as a "treatment." Since the first year that an RHC could join an ACO was 2012 and our most recent year of complete data is 2013, we restricted our analysis of the impact of participation in an ACO to include only 2012 and 2013 data. The estimates of the average treatment effect on the treated (ATET) pertain to only those RHCs that joined ACOs. The results show that those 20 sample ACO RHCs experienced an average from $15.00 to $18.61 higher cost per visit than the matching non-ACO RHCs. At this very early stage of ACO development, our results must be considered very preliminary at best. Whatever conclusions we draw from these results are intended to merely suggest what might be found once many more RHCs join ACOs. The conclusions we draw from this early analysis can lay a foundation for more analysis after data are available when more RHCs join ACOs.
Topic(s):
Financing & Sustainability
See topic collection
, Healthcare Disparities
See topic collection
Reference Links: View the PubMed citation for Cost of Practice Transformation in Primary Care: Joining an Accountable Care Organization
2603
Cost savings associated with an alternative payment model for integrating behavioral health in primary care
Type: Journal Article
Year: 2018
Abstract: Financially supporting and sustaining behavioral health services integrated into primary care settings remains a major barrier to widespread implementation. Sustaining Healthcare Across Integrated Primary Care Efforts (SHAPE) was a demonstration project designed to prospectively examine the cost savings associated with utilizing an alternative payment methodology to support behavioral health services in primary care practices with integrated behavioral health services. Six primary care practices in Colorado participated in this project. Each practice had at least one on-site behavioral health clinician providing integrated behavioral health services. Three practices received non-fee-for-service payments (i.e., SHAPE payment) to support provision of behavioral health services for 18 months. Three practices did not receive the SHAPE payment and served as control practices for comparison purposes. Assignment to condition was nonrandom. Patient claims data were collected for 9 months before the start of the SHAPE demonstration project (pre-period) and for 18 months during the SHAPE project (post-period) to evaluate cost savings. During the 18-month post-period, analysis of the practices' claims data demonstrated that practices receiving the SHAPE payment generated approximately $1.08 million in net cost savings for their public payer population (i.e., Medicare, Medicaid, and Dual Eligible; N = 9,042). The cost savings were primarily achieved through reduction in downstream utilization (e.g., hospitalizations). The SHAPE demonstration project found that non-fee-for-service payments for behavioral health integrated into primary care may be associated with significant cost savings for public payers, which could have implications on future delivery and payment work in public programs (e.g., Medicaid).
Topic(s):
Financing & Sustainability
See topic collection
Reference Links:
View the DOI record for Cost savings associated with an alternative payment model for integrating behavioral health in primary care
View DOI Record
View the PubMed citation for Cost savings associated with an alternative payment model for integrating behavioral health in primary care2604
Cost utility analysis of a collaborative stepped care intervention for panic and generalized anxiety disorders in primary care
Type: Journal Article
Year: 2014
Publication Place: England
Topic(s):
Financing & Sustainability
See topic collection
2606
Cost-effectiveness analysis of a collaborative care programme for depression in primary care
Type: Journal Article
Year: 2014
Publication Place: Netherlands
Topic(s):
Financing & Sustainability
See topic collection
Reference Links:
View the DOI record for Cost-effectiveness analysis of a collaborative care programme for depression in primary care
View DOI Record
View the PubMed citation for Cost-effectiveness analysis of a collaborative care programme for depression in primary care2608
Cost-effectiveness analysis of a rural telemedicine collaborative care intervention for depression
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: CONTEXT: Collaborative care interventions for depression in primary care settings are clinically beneficial and cost-effective. Most prior studies were conducted in urban settings. OBJECTIVE: To examine the cost-effectiveness of a rural telemedicine-based collaborative care depression intervention. DESIGN: Randomized controlled trial of intervention vs usual care. SETTING: Seven small (serving 1000 to 5000 veterans) Veterans Health Administration community-based outpatient clinics serving rural catchment areas in 3 mid-South states. Each site had interactive televideo dedicated to mental health but no psychiatrist or psychologist on site. Patients Among 18 306 primary care patients who were screened, 1260 (6.9%) screened positive for depression; 395 met eligibility criteria and were enrolled from April 2003 to September 2004. Of those enrolled, 360 (91.1%) completed a 6-month follow-up and 335 (84.8%) completed a 12-month follow-up. Intervention A stepped-care model for depression treatment was used by an off-site depression care team to make treatment recommendations via electronic medical record. The team included a nurse depression care manager, clinical pharmacist, and psychiatrist. The depression care manager communicated with patients via telephone and was supported by computerized decision support software. MAIN OUTCOME MEASURES: The base case cost analysis included outpatient, pharmacy, and intervention expenditures. The effectiveness outcomes were depression-free days and quality-adjusted life years (QALYs) calculated using the 12-Item Short Form Health Survey standard gamble conversion formula. RESULTS: The incremental depression-free days outcome was not significant (P = .10); therefore, further cost-effectiveness analyses were not done. The incremental QALY outcome was significant (P = .04) and the mean base case incremental cost-effectiveness ratio was $85 634/QALY. Results adding inpatient costs were $111 999/QALY to $132 175/QALY. CONCLUSIONS: In rural settings, a telemedicine-based collaborative care intervention for depression is effective and expensive. The mean base case result was $85 634/QALY, which is greater than cost per QALY ratios reported for other, mostly urban, depression collaborative care interventions.
Topic(s):
Financing & Sustainability
See topic collection
, HIT & Telehealth
See topic collection
, Healthcare Policy
See topic collection
Reference Links:
View the DOI record for Cost-effectiveness analysis of a rural telemedicine collaborative care intervention for depression
View DOI Record
View the PubMed citation for Cost-effectiveness analysis of a rural telemedicine collaborative care intervention for depression2610
Cost-effectiveness analysis of collaborative care management of major depression among low-income, predominantly Hispanics with diabetes
Type: Journal Article
Year: 2011
Abstract: Abstract. OBJECTIVE: To evaluate the cost-effectiveness of a socioculturally adapted collaborative depression care program among low-income Hispanics with diabetes. RESEARCH DESIGN AND METHODS: A randomized controlled trial of 387 patients with diabetes (96.5% Hispanic) with clinically significant depression followed over 18 months evaluated the cost-effectiveness of the Multifaceted Diabetes and Depression Program aimed at increasing patient exposure to evidence-based depression psychotherapy and/or pharmacotherapy in two public safety net clinics. Patient medical care costs and utilization were captured from Los Angeles County Department of Health Services claims records. Patient-reported outcomes included Short-Form Health Survey-12 and Patient Health Questionnaire-9-calculated depression-free days. RESULTS: Intervention patients had significantly greater Short-Form Health Survey-12 utility improvement from baseline compared with controls over the 18-month evaluation period (4.8%; P < 0.001) and a corresponding significant improvement in depression-free days (43.0; P < 0.001). Medical cost differences were not statistically significant in ordinary least squares and log-transformed cost regressions. The average costs of the Multifaceted Diabetes and Depression Program study intervention were $515 per patient. The program's cost-effectiveness averaged $4053 per quality-adjusted life-year per MDDP recipient and was more than 90% likely to fall below $12,000 per quality-adjusted life-year. CONCLUSIONS: Socioculturally adapted collaborative depression care improved utility and quality of life in predominantly low-income Hispanic patients with diabetes and was highly cost-effective.
Topic(s):
Financing & Sustainability
See topic collection
2613
Cost-effectiveness and cost offset of a collaborative care intervention for primary care patients with panic disorder
Type: Journal Article
Year: 2002
Publication Place: United States
Abstract: BACKGROUND: A collaborative care (CC) intervention for patients with panic disorder that provided increased patient education and integrated a psychiatrist into primary care was associated with improved symptomatic and functional outcomes. This report evaluates the incremental cost-effectiveness and potential cost offset of a CC treatment program for primary care patients with panic disorder from the perspective of the payer. METHODS: We randomly assigned 115 primary care patients with panic disorder to a CC intervention that included systematic patient education and approximately 2 visits with an on-site consulting psychiatrist, compared with usual primary care. Telephone assessments of clinical outcomes were performed at 3, 6, 9, and 12 months. Use of health care services and costs were assessed using administrative data from the primary care clinics and self-report data. RESULTS: Patients receiving CC experienced a mean of 74.2 more anxiety-free days during the 12-month intervention (95% confidence interval [CI], 15.8-122.0). The incremental mental health cost of the CC intervention was $205 (95% CI, -$135 to $501), with the additional mental health costs of the intervention explained by expenditures for antidepressant medication and outpatient mental health visits. Total outpatient cost was $325 (95% CI, -$1460 to $448) less for the CC than for the usual care group. The incremental cost-effectiveness ratio for total ambulatory cost was -$4 (95% CI, -$23 to $14) per anxiety-free day. Results of a bootstrap analysis suggested a 0.70 probability that the CC intervention was dominant (eg, lower costs and greater effectiveness). CONCLUSION: A CC intervention for patients with panic disorder was associated with significantly more anxiety-free days, no significant differences in total outpatient costs, and a distribution of the cost-effectiveness ratio based on total outpatient costs that suggests a 70% probability that the intervention was dominant, compared with usual care.
Topic(s):
Financing & Sustainability
See topic collection
Reference Links:
View the DOI record for Cost-effectiveness and cost offset of a collaborative care intervention for primary care patients with panic disorder
View DOI Record
View the PubMed citation for Cost-effectiveness and cost offset of a collaborative care intervention for primary care patients with panic disorder2614
Cost-Effectiveness Evaluation of Collaborative Care for Diabetes and Depression in Primary Care
Type: Journal Article
Year: 2016
Publication Place: Netherlands
Topic(s):
Education & Workforce
See topic collection
, Financing & Sustainability
See topic collection
Reference Links:
View the DOI record for Cost-Effectiveness Evaluation of Collaborative Care for Diabetes and Depression in Primary Care
View DOI Record
View the PubMed citation for Cost-Effectiveness Evaluation of Collaborative Care for Diabetes and Depression in Primary Care2615
Cost-effectiveness implications of increasing the efficiency of the extended-release naltrexone induction process for the treatment of opioid use disorder: a secondary analysis
Type: Journal Article
Year: 2021
Topic(s):
Education & Workforce
See topic collection
, Financing & Sustainability
See topic collection
, Opioids & Substance Use
See topic collection
2617
Cost-effectiveness of a care manager collaborative care programme for patients with depression in primary care: economic evaluation of a pragmatic randomised controlled study
Type: Journal Article
Year: 2018
Publication Place: England
Topic(s):
Financing & Sustainability
See topic collection
2618
Cost-effectiveness of a collaborative care program for managing major depression and chronic musculoskeletal pain in primary care: Economic evaluation alongside a randomized controlled trial
Type: Journal Article
Year: 2020
Publication Place: England
Topic(s):
Financing & Sustainability
See topic collection
, Healthcare Disparities
See topic collection
2619
Cost-effectiveness of a collaborative care program for primary care patients with persistent depression
Type: Journal Article
Year: 2001
Publication Place: United States
Abstract: OBJECTIVE: The authors evaluated the incremental cost-effectiveness of stepped collaborative care for patients with persistent depressive symptoms after usual primary care management. METHOD: Primary care patients initiating antidepressant treatment completed a standardized telephone assessment 6-8 weeks after the initial prescription. Those with persistent major depression or significant subthreshold depressive symptoms were randomly assigned to continued usual care or collaborative care. The collaborative care included systematic patient education, an initial visit with a consulting psychiatrist, 2-4 months of shared care by the psychiatrist and primary care physician, and monitoring of follow-up visits and adherence to medication regimen. Clinical outcomes were assessed through blinded telephone assessments at 1, 3, and 6 months. Health services utilization and costs were assessed through health plan claims and accounting data. RESULTS: Patients receiving collaborative care experienced a mean of 16.7 additional depression-free days over 6 months. The mean incremental cost of depression treatment in this program was $357. The additional cost was attributable to greater expenditures for antidepressant prescriptions and outpatient visits. No offsetting decrease in use of other health services was observed. The incremental cost-effectiveness was $21.44 per depression-free day. CONCLUSIONS: A stepped collaborative care program for depressed primary care patients led to substantial increases in treatment effectiveness and moderate increases in costs. These findings are consistent with those of other randomized trials. Improving outcomes of depression treatment in primary care requires investment of additional resources, but the return on this investment is comparable to that of many other widely accepted medical interventions.
Topic(s):
Financing & Sustainability
See topic collection
, Key & Foundational
See topic collection
Reference Links: View the PubMed citation for Cost-effectiveness of a collaborative care program for primary care patients with persistent depression
2620
Cost-effectiveness of a disease management program for major depression in elderly primary care patients
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: BACKGROUND: Major depression is common in older adults and is associated with increased health care costs. Depression often remains unrecognized in older adults, especially in primary care. OBJECTIVE: To evaluate the cost-effectiveness of a disease management program for major depression in elderly primary care patients compared with usual care. DESIGN: Economic evaluation alongside a cluster randomized-controlled trial. PARTICIPANTS: Consecutive patients of 55 years and older were screened for depression using the Geriatric Depression Scale and the PRIME-MD was used for diagnosis. INTERVENTIONS: General practitioners in the intervention group received training on how to implement the disease management program consisting of screening, patient education, drug therapy with paroxetine, and supportive contacts. General practitioners in the usual care group were blind to the screening results. Treatment in this group was not restricted in any way. MEASUREMENTS: Severity of depression, recovery from depression, and quality of life. Resource use measured over a 12-month period using interviews and valued using standard costs. RESULTS: Differences in clinical outcomes between the intervention and usual care group were small and statistically insignificant. Total costs were 2,123 dollars in the intervention and 2,259 dollars in the usual care group (mean difference -136 dollars, 95% confidence interval: -1,194 dollars; 1,110 dollars). Cost-effectiveness planes indicated that there were no statistically significant differences in cost-effectiveness between the 2 groups. CONCLUSIONS: This disease management program for major depression in elderly primary care patients had no statistically significant relationship with clinical outcomes, costs, and cost-effectiveness. Therefore, based on these results, continuing usual care is recommended.
Topic(s):
Financing & Sustainability
See topic collection
Reference Links:
View the DOI record for Cost-effectiveness of a disease management program for major depression in elderly primary care patients
View DOI Record
View the PubMed citation for Cost-effectiveness of a disease management program for major depression in elderly primary care patients