Community programs designed to address the behavioral and mental health of citizens face many obstacles, including accurate assessment tools. Many social services that are aimed at improving the psychological health of individuals on low-income subsidy or disability provide resources and therapies for people but are unable to achieve significant gains. Doctors that participate in these programs are usually primary care doctors. They are often ill-equipped to handle the demands of behaviorally challenged individuals due to limited financial resources and patient overload. These doctors most likely try their best to help every client, but without proper tracking and assessments, care often falls short.
For individuals with depression, posttraumatic stress, substance abuse, and other problems common among the disabled and economically limited, continuous evaluation is necessary to determine if the course of treatment is effective. When results are not being achieved, it is important for doctors to recognize this and make the necessary changes in order to ensure the client can continue to make positive progress. “When these problems are not effectively treated, they can impair self-care and adherence to medical and mental health treatments and are associated with increased mortality and increased overall health care costs,” said Jurgen Unutzer of the Department of Psychiatry and Behavioral Sciences at the University of Washington in Seattle.
Unutzer recently led a study that analyzed the effectiveness of a doctor incentive program (P4P) in a large sample of depressed individuals being served at 29 community health facilities. He evaluated 1,673 clients who were treated before the incentives were implemented and 6,304 clients who were treated after P4P. Unutzer found that the clients treated after the incentive program not only improved more quickly than those treated before P4P but also achieved greater symptom reductions. Unutzer believes that the stringent guidelines required to receive monetary incentives motivates doctors to perform more thorough and timely assessments of their clients and encourages them to use a measurement-based stepped care strategy to ensure their clients are being treated in the most effective way possible. These results demonstrate that incentive programs are valuable not only to doctors but also to the clinical population they serve.
Unutzer, J., Chan, Y.-F. Hafer, E., Knaster, J., Shields, A. (2012). Quality improvement with pay-for-performance incentives in integrated behavioral health care. American Journal of Public Health, 102.6, E41-E45.
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