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Home / News & IndustryManaged Care Insight and Analysis
Updated: Nov. 4, 2008
New Approach For Improving Depression Care Introduced At 10 Minnesota Clinics

Ten primary care clinics in the Twin Cities, Duluth and Rochester are the first in Minnesota to offer a new approach for caring for patients with depression, according to the Institute for Clinical Systems Improvement (ICSI).

To date, 234 patients have been enrolled in the program – called Depression Improvement Across Minnesota, Offering a New Direction (DIAMOND) – since it began in March, ICSI said.

The program is the result of a collaboration between dozens of Minnesota medical groups, six regional health plans and the Minnesota Department of Human Services. Their efforts have been guided by the ICSI, a non-profit organization that brings medical groups, health plans, patients, healthcare purchasers and other constituencies together to develop solutions to problems in healthcare.

Key elements of DIAMOND include use of a standard assessment tool to improve the diagnosis and management of depression in the primary care clinic, the addition of a care manager and consulting psychiatrist to the patient’s treatment team, tools to prevent the patient from relapsing and a tracking system to monitor follow-up care and treatment effectiveness. The model allows for comprehensive care with constant information sharing among the care providers, ICSI said.

Additional medical groups and clinics are completing training and other preparations through ICSI to become certified to offer the program. At least 90 primary care clinics in large and small communities across Minnesota and northern Wisconsin plan to be using the DIAMOND model by March 2010, according to ICSI.

Clinical trials have demonstrated that use of this model in the primary care setting reduces the incidence of suicidal thoughts, puts patients in remission faster, results in 100 additional productive days over a two-year period and reduces healthcare costs by more than $3,000 over a four-year period compared to patients who receive the usual primary care treatment and/or referral approach for depression, ICSI said.

DIAMOND also features a new payment structure. DIAMOND requires medical groups to establish a care manager role and make other changes in their depression care practices.

Through ICSI, health plans and medical groups worked together on a new pay model whereby medical groups receive a periodic fee from health plans that covers the costs of these services. The health plansand medical groups negotiated the reimbursement rates individually.

Without changes to payment structures, medical groups would not be able to provide the care manager and consulting psychiatrist services to patients, ICSI said.

Address: Institute for Clinical Systems Improvement, 8009 34th Ave. South, Suite 1200, Bloomington, MN 55425; (952) 814-7060,

  This article was taken from:
The Executive Report on Managed Care

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