Randomized trials demonstrate that depression management can improve clinical and work outcomes sufficiently for selected employers to realize a return on investment for purchasing evidence-based care. Rather than the usual care (UC) marketing which uses voltage-enhanced promises to sell voltage-diminished products, evidence-based (EB) presentations can encourage employers to purchase a depression management product that offers the type, intensity and duration of care shown to provide clinical and organizational value. In an RCT conducted in 400 employer members of 20 regional business coalitions, the research team proposes: (1) to compare the impact of evidence- based (EB) to usual care (UC) presentations on employer benefit purchasing behavior, (2) to identify mediators of intervention impact on purchasing behavior, (3) to identify organizational-level moderators of purchasing behavior, and (4) to identify coalition-level moderators of intervention impact on purchasing behavior. This study addresses what policy analysts argue is one of the most pivotal problems in the translation of evidence- based care to `real world'settings: whether purchasers can be influenced to buy health care products on the basis of value rather than cost. In the likely event that EB >UC, the study will provide encouragement to use an evidence-based approach to market new mental health care products to private purchasers on the basis of the product's clinical and organizational value. UC may achieve comparable outcomes to EB if the limiting factors in benefit purchasing are organizational, purchasing group and vendor constraints that no intervention can meaningfully modify. Support for this scenario would encourage the targeted marketing of new mental health products to coalition members with selected organizational, purchasing group and vendor characteristics, using usual care strategies.
The first specific aim of the proposed project is to compare the impact evidence-based marketing presentations and usual vendor marketing on employer benefit purchasing behavior. The second specific aim of this project is to identify mediators of intervention impact on employer benefit purchasing behavior. The third specific aim of the project is to identify organizational-level moderators of employer benefit purchasing behavior. The fourth specific aim is to identify coalition-level moderators of intervention impact on employer benefit purchasing behavior. This study addresses what policy analysts argue is one of the most pivotal problems in the translation of evidence-based care to `real world'settings: how purchasers can be influenced to buy health care products on the basis of value rather than cost.
| Rost, Kathryn M; Marshall, Donna; Xu, Stanley (2014) Intervention impact on depression product appraisal and purchasing behavior by employers: a randomized trial. BMC Health Serv Res 14:426 |
| Rost, Kathryn M; Meng, Hongdao; Xu, Stanley (2014) Work productivity loss from depression: evidence from an employer survey. BMC Health Serv Res 14:597 |
| Robst, John; Rost, Kathryn; Marshall, Donna (2013) Do employers know the quality of health care benefits they provide? Use of HEDIS depression scores for health plans. Psychiatr Serv 64:1134-9 |
| Rost, Kathryn; Marshall, Donna; Shearer, Benjamin et al. (2011) Depression care management: can employers purchase improved outcomes? Depress Res Treat 2011:942519 |
| Rost, Kathryn M; Marshall, Donna (2010) Marketing depression care management to employers: design of a randomized controlled trial. Implement Sci 5:22 |
