Designing Payment and Performance Evaluation for Depression Care Management

简介（申请人提供）：包玉华，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指导研究科学家职业发展（K01）奖将为鲍博士成功过渡到独立的精神卫生服务研究者提供必要的支持，其职业目标是提供急需的证据，为旨在将循证精神卫生治疗整合到一般医疗环境中的政策提供信息。拟议的培训计划包括一系列学习活动，使候选人能够获得一般医疗环境中心理健康状况和治疗方面的知识，发展在设计和评估绩效指标以及奖励医疗环境中循证精神卫生保健的支付政策方面的技能和专业知识，并发展在评估利益相关者对激励机制设计的接受程度方面的技能和经验。在这些学习活动的基础上，研究项目将在两种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，将进行基于先前和正在进行的研究的数据分析，以设计与提供基于证据的抑郁症护理管理的成本相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估计提供者特定的结果、通过半结构化小组访谈（家庭卫生保健）和将使用决策分析方法设计的调查收集初级数据（初级保健）来评估。拟议的培训和研究活动旨在为鲍博士提供额外的经验和必要的资源，以支持在奖项结束前成功提交R01拨款，以设计和评估正在不断发展的综合医疗支付系统中基于证据的精神卫生保健的激励措施。

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.