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3. Comparative Effectiveness Research

Explore outcome variation in large implementations of integrated care and empirically identify best practices

Brief Description

  1. Combine existing patient-level outcome data from large existing implementations of collaborative care (e.g. MHIP, DIAMOND, RESPECT-MIL, VA) to determine patient-, provider-, clinic-, and organization-level factors associated with favorable outcomes.
  2. Use this data to identify ‘best practices’ in collaborative care and generate hypotheses regarding multi-level factors associated with effective collaborative care.
    1. Specifically, analyze outcome variation and identify ‘best practices’ for integrated care in the context of patient-centered medical homes.

 

Opportunity (Why Now?)

  1. We have patient-level outcome data (PHQ-9s) for over 40,000 patients who have received depression care in one of several large-scale implementations of Collaborative Care to date. We also have information on patient, provider, clinic, and organizations factors that may be associated with variation in outcomes when such programs are implemented in large real world health care settings. Observational studies to fully explore such variation in large-scale implementations can help identify important factors and strategies for successfully implementing evidence-based integrated care programs nationally.
  2. A subset of the several hundred practices participating in these large scale implementations are transforming into Patient Centered Medical Homes (PCMHs).
  3. Level 2 NCQA PCMHs are supposed to include behavioral health but little information is available on the most effective approaches to integrating and providing behavioral health care in the context of PCMHs.
  4. The proposed analyses can help identify the most promising strategies in the context of PCMHs.
  5. Funding opportunities
  6. PCORI, the patient-centered outcomes research institute
  7. AHRQ CER Portfolio
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