title: Evaluating Depression Care Management in a Community Setting: Main Outcomes for a Medicaid HMO Population with Multiple Medical and Psychiatric Comorbidities.
abstract: The authors describe the implementation of a depression care management (DCM) program at Colorado Access, a public sector health plan, and describe the program's clinical and system outcomes for members with chronic medical conditions. High medical risk, high cost Medicaid health plan members were identified and systematically screened for depression. A total of 370 members enrolled in the DCM program. Longitudinal analyses revealed significantly reduced depression severity scores at 3, 6, and 12 months after intervention as compared to baseline depression scores. At 12 months, 56% of enrollees in the DCM program had either a 50% reduction in PHQ-9 scores or a PHQ-9 score < 10. Longitudinal economic analyses comparing 12 months before and after intervention revealed a significant but modest increase in ER visits, outpatient office visits, and overall medical and pharmacy costs when adjusted for months enrolled in DCM. Limitations and recommendations for the integrated depression care management are discussed.
authors.affiliation: University of Colorado Denver (UCD) Depression Center and Department of Psychiatry, University of Colorado School of Medicine, Building 500, 13001 E. 17th Place, Aurora, CO 80045, USA ; Colorado Access, 10065 E. Harvard Avenue, Suite 600, Denver, CO 80045, USA.
authors.forename: Jeanette A
authors.initials: JA
authors.lastname: Waxmonsky
authors.forename: Marshall
authors.initials: M
authors.lastname: Thomas
authors.forename: Alexis
authors.initials: A
authors.lastname: Giese
authors.forename: Steve
authors.initials: S
authors.lastname: Zyzanski
authors.forename: L Miriam
authors.initials: LM
authors.lastname: Dickinson
authors.forename: Gretchen Flanders
authors.initials: GF
authors.lastname: McGinnis
authors.forename: Paul
authors.initials: P
authors.lastname: Nutting