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A Collaborative Approach to Identifying Effective Incentives for Mental Health Clinicians to Improve Depression Care in a Large Managed Behavioral Healthcare Organization

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Abstract

This descriptive study used stakeholder input to prioritize evidence-based strategies for improving depression care and to select incentives for mental health clinicians to adopt those strategies, and to conduct a feasibility test of an incentive-based program in a managed behavioral healthcare organization (MBHO). In two rounds of interviews and a stakeholder meeting, MBHO administrators and clinicians selected increasing combination treatment (antidepressant plus psychotherapy) rates as the program goal; and paying a bonus for case reviews, clinician feedback, and clinician education as incentives. We assessed program feasibility with case review and clinician surveys from a large independent practice association that contracts with the MBHO. Findings suggest that providing incentives for mental health clinicians is feasible and the incentive program did increase awareness. However, adoption may be challenging because of administrative barriers and limited clinical data available to MBHOs.

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Acknowledgments

The study team thanks Michael Schoenbaum, Ph.D. for his early contributions to conceptualizing this work and Gery Ryan, Ph.D. for his guidance on the qualitative research processes used. The authors also wish to acknowledge Mindy Morefield, M.A. and Yuting Wong, B.A. for their able research assistance and Jony Weiss, M.P.H. for her panel facilitation skills. Participation by members of the OHBS community in all phases of the research study vastly improved the promise of QI for depression and are greatly appreciated for their contribution. The authors also thank Richard Rodriquez at OHBS and Randy Davis, PhD at College Health IPA for their guidance with decisions about implementation and Florence (Toni) Christopher for assistance with manuscript preparation. This research was supported by a grant to Dr. Wells from NIMH (grant # P30MH068639). Earlier versions of this article were presented at the annual meeting of AcademyHealth, Boston, Massachusetts, June, 2005 and the Academy of Psychosomatic Medicine, Tucson, Arizona, November, 2006.

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Authors and Affiliations

  1. RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA

    Lisa S. Meredith

  2. Research and Evaluation, Optum Health Behavioral Solutions, 425 Market St. 14th Floor, San Francisco, CA, 94105, USA

    Robert B. Branstrom & Francisca Azocar

  3. College Health IPA, 17100 Pioneer Blvd., Suite 420, Cerritos, CA, 90701, USA

    Ruth Fikes

  4. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Plaza, Room 106, Box 951736, Los Angeles, CA, 90095-1736, USA

    Susan L. Ettner

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  1. Lisa S. Meredith
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  2. Robert B. Branstrom
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Correspondence to Lisa S. Meredith.

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Meredith, L.S., Branstrom, R.B., Azocar, F. et al. A Collaborative Approach to Identifying Effective Incentives for Mental Health Clinicians to Improve Depression Care in a Large Managed Behavioral Healthcare Organization. Adm Policy Ment Health 38, 193–202 (2011). https://doi.org/10.1007/s10488-010-0313-0

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