Clinical trial NCT04106388: Virtual Behavioral Health Integration
Official title: An Evaluation of Virtual Behavioral Health Integration Into Primary Care
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Depression
Substance Use Disorder
Anxiety
Lead sponsor: Wake Forest University Health Sciences
Sponsor class: OTHER
First posted: 2019-09-27
Enrollment: 5777
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Locations offering the program are randomized
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The primary objective is to evaluate the effectiveness of the virtual behavioral health integration (VBHI) program compared to usual care, on reducing the total cost of care reimbursed from Medicare and value-based contracts within 90 days of a patient's primary care visit.

Detailed description: To enhance the care of patients seen in the primary care setting, Atrium Health has designed a virtual behavioral health integration program. A behavioral health care team comprised of licensed clinicians (Behavioral Health Professionals), health coaches, a consulting psychiatric pharmacist and psychiatric providers follow patients for up to 3 months or more depending on patient need after their primary care office visit. This virtual behavioral health integration (VBHI) program is currently available in 36 Atrium Health primary care practices providing support to over 200 providers and medical residents. The Behavioral health Service line is expanding the program to additional primary care practices. Atrium Health and the Carolinas Physician Alliance is interested in evaluating the effectiveness of the program on reducing the total cost of care.

Eligibility criteria: Inclusion Criteria:

* 18 years of age or older
* Primary care office visit
* Have a Patient Health Questionnaire-9 (PHQ-9) and overall score \>=10 or Question 9 \>0
* Medicare or value-based contract associated with a patient in the past year at the time of the primary care visit.

Exclusion Criteria:

* A patient will contribute to the analysis once using their initial enrollment to either arm of the study.
* No insurance claim for the index primary care visit in the data warehouse upon evaluation.

Primary outcomes:
measure: Cost of Care
timeFrame: 90 days from a patient's primary care visit
Secondary outcomes:
measure: Compare the 90-day acute care utilization rate after the index primary care visit
timeFrame: 90 days from a patient's primary care visit
measure: Compare the 90-day primary care utilization rate after the index primary care visit
timeFrame: 90 days from a patient's primary care visit
measure: pharmacy Cost of Care
timeFrame: 90 days from a patient's primary care visit
Other outcomes:
Locations:
city: Albemarle
country: United States
facility: Albermarle Medical Services
state: North Carolina
city: Charlotte
country: United States
facility: Charlotte Medical Clinic Arboretum
state: North Carolina
city: Charlotte
country: United States
facility: North Charlotte Medical Specialists Huntersville
state: North Carolina
city: Charlotte
country: United States
facility: Mecklenburg Medical Group - Steele Creek
state: North Carolina
city: Concord
country: United States
facility: NorthEast Internal and Integrative Medicine
state: North Carolina
city: Denver
country: United States
facility: East Lincoln Primary Care
state: North Carolina
city: Gastonia
country: United States
facility: Riverwood Medical Associates
state: North Carolina
city: Harrisburg
country: United States
facility: Ardsley Internal Medicine - Harrisburg
state: North Carolina
city: Indian Trail
country: United States
facility: Dove Internal Medicine Union West
state: North Carolina
city: Indian Trail
country: United States
facility: Indian Trail Family Medicine
state: North Carolina
city: Kannapolis
country: United States
facility: Kannapolis Internal Medicine
state: North Carolina
city: Kings Mountain
country: United States
facility: Kings Mountain Internal Medicine
state: North Carolina
city: Lincolnton
country: United States
facility: West Lincoln Family Medicine
state: North Carolina
city: Monroe
country: United States
facility: Dove Internal Medicine - Monroe
state: North Carolina
city: Monroe
country: United States
facility: Union Family Practice
state: North Carolina
city: Mooresville
country: United States
facility: Mooresville Internal Medicine Associates
state: North Carolina
city: Oakboro
country: United States
facility: Oakboro Medical Services
state: North Carolina
city: Richfield
country: United States
facility: Richfield Medical Services
state: North Carolina
city: Shelby
country: United States
facility: Shelby Family Practice
state: North Carolina
city: Wesley Chapel
country: United States
facility: Union Primary Care
state: North Carolina
Study officials:
affiliation: Wake Forest University Health Sciences
name: Jason Roberge, PhD
role: PRINCIPAL_INVESTIGATOR
References: