Improving Depression Treatment in Managed Primary Care Practices

In response to the need for strategies that encourage managed care organizations, physician groups, and patients to adopt existing treatments, the RAND Corporation conducted a study called Partners in Care that was designed to improve the treatment of depression in primary care cost effectively. A collaborative care model that uses nonphysicians to improve coordination between the primary care provider and the mental health specialist was adapted for the study. In the RAND study, nurses and physician assistants are used for that purpose instead of physicians whenever possible. RAND implemented that approach in 46 primary care clinics with a total of 181 providers. The effectiveness of the program is being evaluated, with a focus on the costs of screening for depression, implementation of such a model, and treatment. Consideration is being given to the cost of enabling other organizations to implement such interventions.