title: Randomized controlled trial of a health plan-level mood disorders psychosocial intervention for solo or small practices.
abstract: BACKGROUND
  Mood disorders represent the most expensive mental disorders for employer-based commercial health plans. Collaborative care models are effective in treating chronic physical and mental illnesses at little to no net healthcare cost, but to date have primarily been implemented by larger healthcare organizations in facility-based models. The majority of practices providing commercially insured care are far too small to implement such models. Health plan-level collaborative care treatment can address this unmet need. The goal of this study is to implement at the national commercial health plan level a collaborative care model to improve outcomes for persons with mood disorders.
  
  
  METHODS
  A randomized controlled trial of a collaborative care model versus usual care will be conducted among beneficiaries of a large national health plan from across the country seen by primary care or behavioral health practices. At discharge 344 patients identified by health plan claims as hospitalized for unipolar depression or bipolar disorder will be randomized to receive collaborative care (patient phone-based self-management support, care management, and guideline dissemination to practices delivered by a plan-level care manager) or usual care from their provider. Primary outcomes are changes in mood symptoms and mental health-related quality of life at 12 months. Secondary outcomes include rehospitalization, receipt of guideline-concordant care, and work productivity.
  
  
  CONCLUSIONS
  This study will determine whether a collaborative care model for mood disorders delivered at the national health plan level improves outcomes compared to usual care, and will inform a business case for collaborative care models for these settings that can reach patients wherever they receive treatment.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT02041962; registered January 3, 2014.
authors.affiliation: VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2215 Fuller Road, Mailstop 152, Ann Arbor, MI 48105 USA ; Department of Psychiatry, University of Michigan Medical School, North Campus Research Complex, 2800 Plymouth Road, Building 16, Ann Arbor, MI 48109-2800 USA.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.affiliation: VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2215 Fuller Road, Mailstop 152, Ann Arbor, MI 48105 USA ; Department of Psychiatry, University of Michigan Medical School, North Campus Research Complex, 2800 Plymouth Road, Building 16, Ann Arbor, MI 48109-2800 USA.
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Nord
authors.affiliation: VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2215 Fuller Road, Mailstop 152, Ann Arbor, MI 48105 USA ; Department of Psychiatry, University of Michigan Medical School, North Campus Research Complex, 2800 Plymouth Road, Building 16, Ann Arbor, MI 48109-2800 USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Kyle
authors.affiliation: VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2215 Fuller Road, Mailstop 152, Ann Arbor, MI 48105 USA ; Department of Psychiatry, University of Michigan Medical School, North Campus Research Complex, 2800 Plymouth Road, Building 16, Ann Arbor, MI 48109-2800 USA.
authors.forename: Celeste
authors.initials: C
authors.lastname: Van Poppelen
authors.affiliation: VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2215 Fuller Road, Mailstop 152, Ann Arbor, MI 48105 USA ; Department of Psychiatry, University of Michigan Medical School, North Campus Research Complex, 2800 Plymouth Road, Building 16, Ann Arbor, MI 48109-2800 USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Goodrich
authors.affiliation: VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2215 Fuller Road, Mailstop 152, Ann Arbor, MI 48105 USA.
authors.forename: Hyungjin Myra
authors.initials: HM
authors.lastname: Kim
authors.affiliation: Department of Health Management and Policy, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029 USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Eisenberg
authors.affiliation: Aetna Healthcare, 980 Jolly Road, Blue Bell, PA 19422 USA.
authors.forename: Hyong
authors.initials: H
authors.lastname: Un
authors.affiliation: Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System 152M, 150 South Huntington Avenue, Boston, MA 02130 USA ; Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA 02215 USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Bauer
keywords: Care management; Depression; Health behavior change; Health plans