Designing Payment and Performance Evaluation for Depression Care Management

简介(申请人提供)：鲍玉华，博士，威尔康奈尔医学院公共卫生系助理教授。这项拟议的NIMH导师研究科学家职业发展奖(K01)将为包博士成功过渡到独立的精神健康服务调查员提供必要的支持，其职业目标是提供急需的证据，为旨在将循证精神健康治疗整合到普通医疗环境中的政策提供参考。拟议的培训计划包括一系列学习活动，使候选人能够了解一般医疗环境中的精神健康状况和治疗，发展设计和评估绩效措施以及激励医疗环境中以证据为基础的精神健康护理的支付政策的技能和专门知识，并发展评估利益攸关方对激励机制设计的接受程度的技能和经验。在这些学习活动的基础上，研究项目将在两个不同的医疗环境中进行：家庭保健和初级保健。在每个项目中，在概念框架的指导下，将根据先前和正在进行的研究进行数据分析，以设计与提供循证抑郁症护理管理的成本一致的替代支付和绩效评估系统。提供者和付款人对这些激励制度的接受程度将通过评估提供者特定的结果，以及通过半结构化小组访谈(家庭保健)和将使用决策分析方法设计的调查(初级保健)收集的主要数据来评估。拟议的培训和研究活动旨在为包博士提供必要的额外经验和资源，以支持在奖项结束前提交成功的R01拨款，以设计和评估在正在不断演变的一般医疗支付系统中综合、以证据为基础的精神卫生保健的激励措施。 公共卫生相关性：美国精神疾病患者的护理质量存在显著差距。在医疗环境中实施以证据为基础的综合精神卫生保健的一个重大障碍是错位的支付系统，在医疗环境中，大约50%的精神卫生保健发生在那里。这份K01申请书提出了一系列培训和研究活动，使包玉华博士能够成功转型为一名独立的精神卫生服务调查员，其工作提供了急需的证据，为旨在将循证精神卫生治疗整合到医疗保健中的政策提供参考。

DESCRIPTION (provided by applicant): Yuhua Bao, Ph.D. is an assistant professor in the Department of Public Health, Weill Cornell Medical College. This proposed NIMH Mentored Research Scientist Career Development (K01) award will provide the necessary support to facilitate Dr. Bao's successful transition to an independent mental health services investigator, with the career goal of providing much-needed evidence to inform policies aimed at integrating evidence-based mental health treatment in general medical settings. The proposed training plan includes a series of learning activities to enable the candidate to gain knowledge of mental health conditions and treatment in general medical settings, to develop skills and expertise in designing and evaluating performance measures as well as payment policies that incentivize evidence-based mental health care in medical settings, and to develop skills and experience in assessing stakeholder acceptance on incentive mechanism designs. Building on these learning activities, research projects will be conducted in two different medical settings: home health care and primary care. In each project, guided by a conceptual framework, data analysis based on previous and on-going research studies will be conducted to design alternative payment and performance evaluation systems that are consistent with the costs of providing evidence- based depression care management. Provider and payer acceptance of these incentive systems will be assessed by estimating provider-specific results, and by primary data collection through semi-structured group interviews (home health care) and a survey that will be designed using decision analytic methods (primary care). The proposed training and research activities are designed to provide Dr. Bao with the additional experience and resources necessary to support the submission of a successful R01 grant by the end of the award to design and evaluate incentives for integrated, evidence-based mental health care in the general medical payment systems that are undergoing continuous evolvement. PUBLIC HEALTH RELEVANCE: Significant gaps exist in the quality of care for Americans with mental illness. A significant barrier to implementation of evidence-based, integrated mental health care in medical settings, where about 50% of all mental health care takes place, is a misaligned payment system. This K01 application proposes a series of training and research activities to enable Dr. Yuhua Bao's successful transition to an independent mental health services investigator whose work provides much-needed evidence to inform policies aimed at integrating evidence-based mental health treatment in medical care.