2004_05 | Depression Programs Might Provide an Edge -
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Published on: 5/31/2004
Last Visited: 5/31/2004
Insurers, for instance, may have an open door to take the lead in putting together better programs and benefits for depression care in Pittsburgh, where a kind of inertia has settled in regarding the condition, according to Michael Schoenbaum, PhD, an economist at the Rand Corp.
While some employers acknowledge the impact of the disease, many have not requested programs from insurers and physicians, in part because employees have not demanded them, according to a study published in Psychiatric Services that polled employers, health plans, and physicians in Pittsburgh.
"We're still not at the point where people are clamoring for access to these programs," says Schoenbaum, the lead author.
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"The evidence is very strong that strategies to improve care for depression are effective, but effective strategies do raise health costs a little bit -- around $250 per year per depressed person, which translates to about $2 per member per month at the population level," says Schoenbaum, citing an earlier study.
Compensate physicians
One way insurers can improve depression care is by paying primary care physicians for care management functions such as regular telephone calls to ensure that patients are taking their medications, a technique that has been proven to work, says Schoenbaum.Health plans also could pay primary care physicians for consulting with specialists about patients, he adds.
"Improvement strategies are centered on how a doctor's office is organized," says Schoenbaum."But if primary care doctors aren't able to bill for phone calls and physician-to-physician consultations, those services are not going to happen systematically.And it's the systematic stuff that works."
President Bush's New Freedom Commission on Mental Health last summer recommended that government and private payers make such changes, says Schoenbaum, but he has yet to hear of the suggested policies being implemented.