title: The economics of depression in primary care: de-fragmentation in the Oregon Medicaid market.
abstract: The Oregon Medicaid program legislatively separates the administration of physical health and mental health services, even though behavioral and physical health conditions significantly impact each other. To overcome this barrier and enhance integrated care, CareOregon, a large Medicaid only health plan partnered with two of its largest provider groups to pilot two different models of integration. In one, an "ownership" model, behavioral health specialists were employed by Federally Qualified Health Center primary care clinics and functioned in a common care model with other providers. In the other, a "loaned" model, behavioral specialists were placed in primary care clinics by community mental health centers and continued to function in a specialty mental health model. The qualitative effects of these two models are discussed.
authors.affiliation: CareOregon, Oregon Health and Sciences University, Portland 97204, Oregon, USA.
authors.forename: David
authors.initials: D
authors.lastname: Labby
authors.forename: Mark
authors.initials: M
authors.lastname: Spofford
authors.forename: Judy
authors.initials: J
authors.lastname: Robison
authors.forename: Rick
authors.initials: R
authors.lastname: Ralston
mesh_terms: D002391:Catchment Area, Health; D003863:Depression / Q000628:therapy; D006801:Humans; D008484:Medicaid; D009922:Oregon; D011320:Primary Health Care / Q000191:economics* / Q000458:organization & administration