Depression Care Management Program Improves Productivity, Reduces Absenteeism at City of Colorado Springs

For some time, the City of Colorado Springs has been proactive in offering health and wellness programs to our employees. As they investigated services for chronic diseases, they discovered that depression is more prevalent than heart disease, asthma and diabetes, affecting one in ten people. They also knew from pharmacy claims data that antidepressants were one of the highest prescriptions filled by the members in their health plan. These facts supported their decision to specifically address depression and its impact on employees and their business.

Disease Management

As a member of the Colorado Business Group on Health, the City was introduced to a program in 2005 called Depression Care Management (DCM). ProCare, a disease management company, offers this program which is focused primarily on depression in the work place.

The City decided to offer the DCM program to its employees, retirees, and eligible dependents over the age of 18, and COBRA medical plan participants. All members in the health plan who meet the eligibility requirements were included since depression not only affects employees but family members as well.

ProCare’s DCM program is a clinically proven way to provide better quality and more effective treatment for people suffering from depression. The program is supported by a registered nurse, or care manager, who provides regular telephone contact with the participant. The role of the care manager is to educate and assist the participant in their understanding of depression, provide regular screenings to monitor progress, and provide a conduit between their therapist and primary care physician if needed. The program is telephonic, providing regular contact between the care manager and the participant. These calls address adherence to medication, possible side effects, and offer coping skills that will help the patient self manage the condition.

The City has 6,200 members who are eligible to participate in the program. From this number, 385 members were identified as possible participants, with 105 participating. This represents a 27% participation rate—right in line with the industry standard of 20-30%.

ProCare utilizes ongoing evaluation to monitor the overall effectiveness of the program and return on investment for employer customers. Evaluations are performed at baseline and every six months for two years using the following standardized, empirically validated instruments:

• PHQ-9, a nine-item depression symptom and severity tool that was created for diagnosing and treating depression in the primary care setting.

• Functional health and well being using the Short Form 36 (SF-36), a 36 question physical and mental health survey.

• Workplace productivity and absenteeism using the 10 question Work Limitations Questionnaire (WLQ-SF).

After six months in the program, significant improvements were realized for the City of Colorado Springs in the severity of depressive symptoms as well as improvements in physical and social functioning. Also, employees reported increased productivity and less time away from work. These results can be calculated directly into cost savings: based on the City’s average hourly wage, the organization realized a savings of $3,136.00 per week based on reduced absenteeism and improved productivity.

To determine a return on investment with DCM, an employer can customize their data in the Return on Investment Calculator, developed by Dr. Kathryn Rost, Elizabeth Freed Professor in Mental Health, Department of Medical Humanities and Social Sciences, Florida State University. This Calculator can be accessed at: www.caremanagementfordepression.org.

Last Updated: May 2008