Project Summary
Background: Workers and families who need mental health care may face delays and not receive treatment that meets their needs and improves outcomes that matter to them. The COVID-19 pandemic and related stresses and traumas have exacerbated these problems. The California Health Care Coalition (the coalition), a nonprofit entity comprising 19 multiemployer health benefits funds and labor groups, seeks to build patient-centered outcomes research/comparative clinical effectiveness research (PCOR/CER) capacity to inform purchaser strategies for effective, timely, patient-centered mental health services. Coalition members provide health benefits to diverse workforces and families, including farm workers, service workers, construction workers, healthcare workers, teachers and education workers, grocery workers, and retail workers.
Proposed Solution to the Problem: The project aims to expand availability of effective mental health services by incorporating PCOR/CER in the health benefits purchasing process. The PCOR/CER focus will be on behavioral health integration and provide a foundation in PCOR/CER for coalition members. Members will review plan features, utilization, provider networks, and patient complaints and experiences to describe current mental health services (in compliance with HIPAA). The coalition will draft a framework to incorporate PCOR/CER in the purchasing process.
Objectives:
- Develop an understanding of PCOR/CER fundamentals; introduce PCOR/CER findings in mental health
- Establish a shared analysis of the current state of mental health services
- Draft framework incorporating opportunities to promote PCOR/CER in health benefits purchasing
- Expand coalition’s PCOR/CER capacity through relationships with researchers, other purchasers, patient advocates, and clinical leaders
- Use learnings from PCOR/CER curriculum and engagement activities in meetings with clinical leaders
Activities: The coalition will collaborate with researchers to build a PCOR/CER curriculum for purchasers, draft a framework for incorporating PCOR/CER in the purchasing process, and invite comment from key stakeholders and peers. Focus groups and interviews will generate qualitative data. The coalition will engage clinical leaders to discuss how PCOR/CER informs care models and treatment plans. At the end of the project period, the coalition will convene partners to reflect and identify priorities for further engagement and dissemination.
Projected Outcomes and Outputs
Short-term outcomes during the project period include:
- A purchaser framework for PCOR/CER that is useful for coalition members, with broad application to health benefits purchasers
- Relationships with researchers who support coalition’s ongoing PCOR/CER capacity-building and dissemination efforts
- List of PCOR/CER strategies for possible alignment across purchasers
- Constructive meetings with clinical leaders in key organizations
Medium-term outcomes (zero to two years post-project period) include: Create a PCOR/CER dissemination plan and engage in coordinated activities to build relationships with clinical leaders.
Long-term outcomes (three and more years post-project period) include: Increase the demand for PCOR/CER informed care by California Health Care Coalition members and other purchasers. Sustain dissemination and member engagement in PCOR/CER.
Patient and Stakeholder Engagement Plan: Primary stakeholders are members of California Health Care Coalition. The 19 multiemployer benefit plans and labor groups will engage in focus groups, interviews, and educational sessions and draft a purchaser framework. The framework will be reviewed by other purchasers and stakeholders with whom the coalition seeks areas of alignment. Other stakeholders include patient advocates and subject matter and technical experts.
Project Collaborators: Researchers, subject matter experts (KP Center for Effectiveness and Safety Research-invited), purchasers (PBGH, National Alliance), and consumer advocates (California Health Access).