Original Paper

Administration and Policy in Mental Health and Mental Health Services Research

, Volume 38, Issue 3, pp 193-202

First online:

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

  • Lisa S. MeredithAffiliated withRAND Corporation Email author 
  • , Robert B. BranstromAffiliated withResearch and Evaluation, Optum Health Behavioral Solutions
  • , Francisca AzocarAffiliated withResearch and Evaluation, Optum Health Behavioral Solutions
  • , Ruth FikesAffiliated withCollege Health IPA
  • , Susan L. EttnerAffiliated withDivision of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA

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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.


Provider behavior change Incentives Mental health services Depression Quality improvement