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APHA Scientific Session and Event Listing

Elizabeth L. Merrick, PhD, MSW¹, Constance M. Horgan, ScD¹, Deborah W. Garnick, ScD¹, Dominic Hodgkin, PhD¹, and Melissa A. Morley, PhD². (1) Schneider Institute for Health Policy, Heller School for Social Policy and Management, Brandeis University, 415 South St, Mailstop 035, Waltham, MA 02454, 781 736 3917, merrick@brandeis.edu, (2) RTI International, 411 Waverly Oaks Road, Suite 330, Waltham, MA 02452

Disease management (DM) has rapidly become a prominent aspect of the health care system in regard to chronic medical disorders. DM programs aim to improve outcomes and reduce costs through a coordinated approach involving better identification, treatment, monitoring and self-management. However, there has been little nationally representative data available regarding health plans' use of DM particularly for depression. Our study documents the prevalence of DM for depression and for several general medical disorders, identifies plan features associated with offering DM, and describes characteristics of depression DM programs. We surveyed 368 commercial health plans in 60 U.S. market areas regarding administrative and clinical aspects of behavioral health care delivery in 2003, yielding national estimates of plan features (83% response rate). We asked whether their commercial managed care products had DM for asthma, congestive heart failure, diabetes, and depression. If they had depression DM, we asked about contracting arrangements and the activities or services provided. We found that a large majority of managed care products had at least one DM program, including about one third offering depression DM. Depression DM programs were typically contracted out rather than managed in-house. Plans that contracted with managed behavioral healthcare organizations for behavioral health services were more likely to have depression DM, and generally used the same vendor for both. There was substantial variation in the provider- and patient-oriented interventions included in depression DM programs. The results provide important information on health plans' adoption of depression DM programs that can significantly affect patient care.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Describe the prevalence of disease management programs for depression and several general medical disorders in private health plans.
• Identify health plan features associated with higher likelihood of offering depression disease management programs.
• Enumerate the most common provider- and patient-focused interventions included in depression disease management programs.

Presenting author's disclosure statement:

Not Answered