Designing Payment and Performance Evaluation for Depression Care Management

描述（由申请人提供）：Yuhua Bao，Ph.D.是威尔康奈尔医学院公共卫生系的助理教授。这个拟议的NIMH指导研究科学家职业发展（K01）奖将提供必要的支持，以促进鲍博士成功过渡到独立的心理健康服务调查员，其职业目标是提供急需的证据，以告知旨在将循证心理健康治疗纳入一般医疗环境的政策。拟议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的精神健康状况和治疗知识，发展设计和评估绩效衡量标准以及奖励医疗环境中循证精神健康护理的支付政策的技能和专业知识，并发展评估利益相关者接受奖励机制设计的技能和经验。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，将在概念框架的指导下，根据以往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。将通过估计提供者特定的结果，以及通过半结构化小组访谈（家庭医疗保健）和使用决策分析方法（初级保健）设计的调查收集的初级数据，评估提供者和付款人对这些激励系统的接受程度。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，以支持在奖励结束时提交成功的R01赠款，以设计和评估正在不断发展的一般医疗支付系统中的综合循证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重大差距。在医疗环境中实施循证综合精神卫生保健的一个重大障碍是不一致的支付系统，约50%的精神卫生保健发生在医疗环境中。K01申请提出了一系列培训和研究活动，以使Yuhua Bao博士成功转型为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纳入医疗保健的政策提供信息。

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.