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Abstract #152261

Jennifer K. Taylor, PhD, Chief Research Officer, Green Ribbon Health, 5201 West Kennedy Blvd., Suite 205, Tampa, FL 33609, 562.221.7200, jennifer.taylor@greenribbonhealth.com, Michael Schoenbaum, PhD, Division of Services and Intervention Research, National Institute of Mental Health, Senior Advisor for Mental Health Services, Epidemiology, and Economics, 6001 Executive Blvd, Room 7142 MSC 9629, Bethesda, MD 20892-9669, Jürgen Unützer, MD, MPH, MA, Director, IMPACT Coordinating Center, Chief of Psychiatry, University of Washington Medical Center, 1959 NE Pacific Street, BB-1661A, Seattle, WA 98195-6560, Wayne Katon, MD, University of Washington School of Medicine, Department of Psychiatry & Behavioral Sciences, Box 356560, 1959 NE Pacific St., Seattle, WA 98195-6560, Harold Alan Pincus, MD, Vice Chair, Department of Psychiatry, Columbia University, Director of Quality and Outcomes Research, New York-Presbyterian Hospital, 1051 Riverside Drive, Unit 09, New York, NY 10032, and Diane M. Hogan, RN, MA, Director of Quality and Outcomes, Green Ribbon Health, 5201 West Kennedy Blvd., Suite 205, Tampa, FL 33609.

Section 721 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 authorized the development and testing of voluntary chronic care improvement programs, now called Medicare Health Support (MHS), to improve the quality of care and life for Medicare Beneficiaries living with multiple chronic illnesses such as complex diabetes and/or congestive heart failure. The authorizing legislation requires that MHS organizations, like Green Ribbon Health (GRH), help beneficiaries manage all their health problems. Major depressive disorder is a serious, prevalent and costly chronic disease, that causes considerable suffering among beneficiaries and GRH has committed to incorporate evidence-based depression management strategies into its MHS program. To date, GRH has screened over 22,000 beneficiaries for depression using the PHQ2 assessment. While prior research indicates that the point prevalence of depression among people with chronic medical illnesses is significant (15% to 25%), GRH found different rates of prevalence depending on the mode of screener administration: Using a telephonically administered PHQ2, only about 5% of this population screened positive for depression, but mailed PHQ2 rates were over 14%. These findings cannot be explained by differences in population characteristics. Rather, significant variances in screening rates across nurse were found while variances in depression diagnoses across nurse were minimal. The findings suggest that nurses had a direct impact on the delivery and/or interpretation of beneficiaries' responses, and that the administration method of depression screening tools matters. The presentation will discuss these findings in the context of how to better identify co-morbid depression in large Medicare populations.

Learning Objectives:

• Describe the goals of Medicare Health Support programs
• Articulate the impact of co-morbid depression in a Medicare population
• Identify three factors that affect the identification of co-morbid depression in a Medicare population

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.