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Depression Research and Treatment
Volume 2012 (2012), Article ID 769298, 8 pages
http://dx.doi.org/10.1155/2012/769298
Research Article

Evaluating Depression Care Management in a Community Setting: Main Outcomes for a Medicaid HMO Population with Multiple Medical and Psychiatric Comorbidities

1University 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
2Colorado Access, 10065 E. Harvard Avenue, Suite 600, Denver, CO 80045, USA
3Case Western Reserve University, Bolwell 1200, 11100 Euclid Avenue, Cleveland, OH 44106, USA
4Department of Family Medicine, University of Colorado Denver, Academic Office 1, 12631 E. 17th Avenue, Aurora, CO 80045, USA
5Center for Research Strategies, 225 E. 16th Avenue, Suite 1150, Denver, CO 80203-1694, USA

Received 31 March 2012; Accepted 17 September 2012

Academic Editor: Mark S. Bauer

Copyright © 2012 Jeanette A. Waxmonsky et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.