The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index.
Quality Improvement With Pay-for-Performance Incentives in Integrated Behavioral Health Care
Open accessAbstract
Objectives. We evaluated a quality improvement program with a pay-for-performance (P4P) incentive in a population-focused, integrated care program for safety-net patients in 29 community health clinics. Methods. We used a quasi-experimental design with 1673 depressed adults before and 6304 adults after the implementation of the P4P program. Survival analyses examined the time to improvement in depression before and after implementation of the P4P program, with adjustments for patient characteristics and clustering by health care organization. Results. Program participants had high levels of depression, other psychiatric and substance abuse problems, and social adversity. After implementation of the P4P incentive program, participants were more likely to experience timely follow-up, and the time to depression improvement was significantly reduced. The hazard ratio for achieving treatment response was 1.73 (95% confidence interval = 1.39, 2.14) after the P4P program implementation compared with pre-program implementation. Conclusions. Although this quasi-experiment cannot prove that the P4P initiative directly caused improved patient outcomes, our analyses strongly suggest that when key quality indicators are tracked and a substantial portion of payment is tied to such quality indicators, the effectiveness of care for safety-net populations can be substantially improved.
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“These initiatives reward providers for outcomes improvement and are also increasingly becoming used in mental health care 90,91 .”
From Measuring and improving the quality of mental health care: a global perspective (2018) · cites this paper as [91]
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Self-citationCollaborative care for patients with depression and chronic illnesses
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Self-citationCollaborative Care for Depression: A Cumulative Meta-analysis and Review of Longer-term Outcomes
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Self-citationImpact of major depression on chronic medical illness
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Implementing Measurement-Based Care in Behavioral Health: A Review
Lewis, C. C., Boyd, M., Puspitasari, A., Navarro, E., Howard, J., Kassab, H., Hoffman, M., Scott, K., Lyon, A., Douglas, S., et al. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.3329 · Cited by 605
A Tipping Point for Measurement-Based Care
Fortney, J. C., Unützer, J., Wrenn, G. L., Pyne, J. M., Smith, G. R., Schoenbaum, M., & Harbin, H. T. (2016) · Psychiatric Services · doi:10.1176/appi.ps.201500439 · Cited by 592
Self-citationMeasuring and improving the quality of mental health care: a global perspective
Kilbourne, A. M., Beck, K., Spaeth‐Rublee, B., Ramanuj, P., O'Brien, R. W., Tomoyasu, N., & Pincus, H. A. (2018) · World Psychiatry · doi:10.1002/wps.20482 · Cited by 457
Grand challenges: integrating mental health services into priority health care platforms
Patel, V., Belkin, G. S., Chockalingam, A., Cooper, J., Saxena, S., & Unützer, J. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001448 · Cited by 356
Self-citationKroenke, K., & Unutzer, J. (2017) · Journal of General Internal Medicine · doi:10.1007/s11606-016-3967-9 · Cited by 231
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Metadata
- Authors
- Unützer, J., Chan, Y.-F., Hafer, E., Knaster, J., Shields, A., Powers, D., & Veith, R. C.
- Affiliations
- Washington State Department of Health (US)
- Jürgen Unützer, Ya-Fen Chan, Diane Powers, and Richard C. Veith are with the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle. Erin Hafer is with the Community Health Plan of Washington, Seattle. Jessica Knaster is with Public Health of Seattle and King County, Seattle, WA. Anne Shields is with the Washington State Department of Health, Olympia, WA.
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2012-06
- Volume
- 102
- Issue
- 6
- Pages
- e41-e45
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC3483954
- OpenAlex
- W2103940893
- Cited by
- 167
- References
- 19
- Citations by year
- 2025: 7 · 2024: 9 · 2023: 3 · 2022: 9 · 2021: 7 · 2020: 13 · 2019: 9 · 2018: 15 · 2017: 13 · 2016: 17 · 2015: 20 · 2014: 21 · 2013: 19 · 2012: 5
- FWCI
- 36.93
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- University of Washington
- Topics
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
- Keywords
- performance-based pay, quality improvement, behavioral health integration, depression treatment, community clinics, quality indicators, treatment response, social adversity, substance abuse, mental illness
- MeSH terms
- Adult, Mental Disorders, Community Health Services, Depression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Physician Incentive Plans, Primary Health Care, Quality of Health Care, Reimbursement, Incentive, United States, Washington, Treatment Outcome, Delivery of Health Care, Integrated
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