Citation

Busch AB, Huskamp HA, Kreider AR, McWilliams JM. Psychiatr. Serv. 2017; 68(11): 1193-1196.

Affiliation

The authors are with the Department of Health Care Policy, Harvard Medical School, Boston. Dr. Busch is also with McLean Hospital, Belmont, Massachusetts. Dr. McWilliams is also with the Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston.

Copyright

(Copyright © 2017, American Psychiatric Association)

DOI

10.1176/appi.ps.201600538

PMID

28712357

Abstract

OBJECTIVE: This study examined whether Medicare accountable care organization (ACO) programs were associated with early changes in antidepressant use or adherence among beneficiaries with depression.

METHODS: A difference-in-difference design was used to compare claims from Medicare fee-for-service beneficiaries (2009-2013) and ACO patients with those from local control groups. Outcome measures were total antidepressant days supplied, filling one or more antidepressant prescriptions, and proportion of days covered (PDC) by supply among antidepressant users (adherence).

RESULTS: Among antidepressant users, ACO contracts were associated with slight differential increases in PDC (.4-.8 percentage point, p≤.03), depending on ACO program and entry year. The proportion of patients with one or more prescriptions was unchanged or decreased slightly for ACO patients with depression, such that total supply did not consistently increase.

CONCLUSIONS: Medicare ACO programs were associated with early modest increases in antidepressant adherence but not with increases in the proportion of patients with depression who received antidepressants.

Language: en

Keywords

Medicare; Quality of care; Service delivery systems; accountable care organizations