ICARE Program Evaluation

Joseph P. Morrissey, PhD, Principal Investigator

Marisa E. Domino, PhD, Co-Investigator

Brad N. Gaynes, MD, MPH, Co-Investigator

Ashley A. Dunham, PhD, MSPH, Research Associate

The ICARE Partnership is conducting four diverse demonstration projects in North Carolina to improve patient outcomes. The projects work to increase communication and collaboration between primary care and MH/DD/SAS providers and to increase their capacity to make informed treatment decisions and provide appropriate care. The Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill has entered into contracts with the North Carolina Foundation for Advanced Health Programs and the North Carolina Division of Medical Assistance to conduct a comprehensive, participatory, process-and-outcome-oriented evaluation of ICARE. The goals of this evaluation are to provide all ICARE partners and other stakeholders with reliable and timely information on the implementation and outcomes of ICARE’s local demonstration projects that can be used to address problems, build on strengths, and leverage future opportunities.

Funded from July 2007 to June 2009, the ICARE evaluation is composed of two distinct parts. The process (formative) evaluation comprises several components that will be conducted at the level of the local demonstration site. First, a Dimensions of Integration Survey will assess ICARE implementation at the four pilot sites, using periodic self-ratings by staff at each ICARE practice on comparable dimensions. Second, an Integration Activities Assessment tool will measure the extent of integration of primary care and behavioral health at each ICARE pilot site including patients treated, number of consultations between behavioral health providers and primary care staff, and time spent by behavioral health providers on-site. Third, Semi-Structured Interviews will be conducted with several ICARE stakeholders and participants at each pilot site. These interviews will provide information on the model successes, changes that occurred, and major barriers and facilitators of change related to the ICARE project. Fourth, Patient Focus Groups will also be conducted with randomly selected ICARE patients at each local demonstration project site to assess their perceptions of the care they have received, how their behavioral health and physical health needs were addressed, and their overall satisfaction with care. The outcome (summative) evaluation includes two activities. First, Medicaid claims data analyses of several health utilization and cost variables will be completed. Second, additional outcome evaluation tools will be determined jointly between the Sheps Center team and each ICARE pilot site according to site-specific evaluation interests.