Effects of a Behavioral Health and Chronic Illness Care Intervention on Patient Outcomes in Primary Care Practices in the Dakotas

Publisher: Journal of Health Care for the Poor and Underserved, vol. 30, no. 2
May 01, 2019
Jelena Zurovac, G. Greg Peterson, Kate A. Stewart, Keith Kranker, KeriAnn Wells, Boyd Gilman, Laura Blue, Timothy Day, Sheila Hoag, and Lorenzo Moreno

From 2012 to 2015, Sanford Health, a large health care system, integrated behavioral health services and chronic condition care management in some of its primary care practices in the Dakotas and rural Minnesota. Using difference-in-differences analyses for fee-for-service Medicare beneficiaries attributed to 22 participating practices and 91 matched comparison practices, we found that the program increased the receipt of four recommended diabetes care processes by 8.6% (p=.048) and, by slowing the increase in emergency department (ED) visits, reduced them by 4.9% (p=.07) relative to the comparison group. However, the findings are mixed: the program did not affect hospital admissions, readmissions, or Medicare spending. In addition, the program increased admissions for ambulatory care–sensitive conditions by 13.6% (p=.07) relative to the comparison group. Sanford's program provides a concrete example of how to incorporate behavioral health services in primary care in underserved areas with some positive results on quality-of-care processes and ED utilization.


HCIA Evaluations: Primary Care Redesign


U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services
U.S. Department of Health and Human Services, Center for Medicare & Medicaid Innovation

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Senior Staff

Jelena Zurovac
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Laura Blue
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Keith Kranker
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Sheila Hoag
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Gregory Peterson
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Boyd Gilman
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