Anxiety, Depression, Substance Use Disorder
Conditions
Brief summary
The primary objective is to evaluate the effectiveness of the virtual behavioral health integration (VBHI) program compared to usual care, on reducing the total cost of care reimbursed from Medicare and value-based contracts within 90 days of a patient's primary care visit.
Detailed description
To enhance the care of patients seen in the primary care setting, Atrium Health has designed a virtual behavioral health integration program. A behavioral health care team comprised of licensed clinicians (Behavioral Health Professionals), health coaches, a consulting psychiatric pharmacist and psychiatric providers follow patients for up to 3 months or more depending on patient need after their primary care office visit. This virtual behavioral health integration (VBHI) program is currently available in 36 Atrium Health primary care practices providing support to over 200 providers and medical residents. The Behavioral health Service line is expanding the program to additional primary care practices. Atrium Health and the Carolinas Physician Alliance is interested in evaluating the effectiveness of the program on reducing the total cost of care.
Interventions
BEHAVIORALVirtual Behavioral Health Integration
The virtual behavioral health integration program, implemented in primary care settings, is a structured mental illness treatment program that includes both behavioral treatment and counseling components aimed at reducing cost of care, developing and sustaining adaptive coping strategies, and improving short term acute care utilization.
Sponsors
Wake Forest University Health Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Intervention model description
Locations offering the program are randomized
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years of age or older * Primary care office visit * Have a Patient Health Questionnaire-9 (PHQ-9) and overall score \>=10 or Question 9 \>0 * Medicare or value-based contract associated with a patient in the past year at the time of the primary care visit.
Exclusion criteria
* A patient will contribute to the analysis once using their initial enrollment to either arm of the study. * No insurance claim for the index primary care visit in the data warehouse upon evaluation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cost of Care | 90 days from a patient's primary care visit | Total cost of care reimbursed from Medicare and value-based contracts |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Compare the 90-day acute care utilization rate after the index primary care visit | 90 days from a patient's primary care visit | Does a patient have an inpatient, observation, or emergency department encounter after their primary care visit |
| Compare the 90-day primary care utilization rate after the index primary care visit | 90 days from a patient's primary care visit | Does a patient have a primary care encounter after their primary care visit |
| pharmacy Cost of Care | 90 days from a patient's primary care visit | Pharmacy related cost of care reimbursed from Medicare and value-based contracts |
Countries
United States
Outcome results
None listed