search
Back to results

Partners in Wellness: Evaluation of a Pay for Performance Program for High-Utilizers of Mental Health Services

Primary Purpose

Psychotic Disorders, Bipolar Disorder, Substance Use Disorders

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Pay For Performance (PFP)
Usual Care (UC)
Sponsored by
Stanford University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Psychotic Disorders

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Individuals with a history of extensive utilization of 24-hour psychiatric services in Santa Clara County, CA and a likelihood of continuing to use them in the future. Exclusion Criteria: Age 17 or younger Born before 1952 Not current resident of the County Currently residing in a state hospital Registered sex offender with legally imposed residency restrictions Have a DSM-V diagnosis of (or meet diagnostic criteria for): Dementia Autism Spectrum Disorder Catatonia Brief Psychotic Disorder Traumatic head injury resulting in severe cognitive impairment IQ of 69 or lower Eating disorders, including Pica, Anorexia Nervosa and Bulimia Nervosa, or Pyromania, or Psychogenic Polydipsia paired with life threatening behaviors in the past 12 months. Serious risk to self (i.e., suicidal intent with specific plan OR command hallucinations for self-harm that were acted on in the last 30 days and resulted in significant physical injury, or without staff intervention would have resulted in significant physical injury. Risk to others (e.g., sexual aggression or other violent, assaultive behavior toward clinical staff in the past 12 months). Serious medical diagnoses that either require intensive and regular home health care (e.g., Cystic Fibrosis, Parkinson's, Cancer), imminent risk of placement in a Skilled Nursing Facility or nursing home (e.g., non-ambulatory; needing would care), or are terminal or are life-threatening. Significant functional impairments (e.g., unable to toilet, incontinent and refuse to wear diaper, refuse to eat or drink, refuse to dress self or wear clothes, unable to transfer in/out of bed)

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Pay For Performance (PFP)

    Usual Care (UC)

    Arm Description

    Participants receive a tailored mix of assertive case management, crisis intervention, substance use counseling, mental health treatment, peer support, skill-building and care coordination, among other services delivered by a provider agency contracted by Santa Clara County. Individual and organizational performance incentives relative to traditional contracted service arrangements were also included. Specifically, the agreement between the contracted provider and the County included an agreed schedule of financial rewards and penalties for the contracted provider based on whether its enrollees utilized more or less care than had a historical cohort of patients enrolled before the program began.

    Participants receive the usual array of mental health and psychosocial services offered by Santa Clara County.

    Outcomes

    Primary Outcome Measures

    Total cost of 24-hour psychiatric services (12 months)
    Total cost of the following care types beginning from enrollment until 12 months post-enrollment: Emergency Psychiatric Services (EPS), Barbara Arons Pavilion (BAP) Acute Psychiatric Inpatient, Contract Hospital, Institutes of Mental Disease (IMD), State Hospital, Crisis Residential, Transitional Residential, Super Board and Care, and Residential Care Facility. Days of utilization for each service were multiplied by estimates of the average costs per client, per day provided by the County. To create the primary outcome measure, costs from all of these sources were summed.
    Total cost of 24-hour psychiatric services (24 months)
    Total cost of the following care types beginning from enrollment until 24 months post-enrollment: Emergency Psychiatric Services (EPS), Barbara Arons Pavilion (BAP) Acute Psychiatric Inpatient, Contract Hospital, Institutes of Mental Disease (IMD), State Hospital, Crisis Residential, Transitional Residential, Super Board and Care, and Residential Care Facility. Days of utilization for each service were multiplied by estimates of the average costs per client, per day provided by the County. To create the primary outcome measure, costs from all of these sources were summed.
    Total cost of 24-hour psychiatric services (36 months)
    Total cost of the following care types beginning from enrollment until 36 months post-enrollment: Emergency Psychiatric Services (EPS), Barbara Arons Pavilion (BAP) Acute Psychiatric Inpatient, Contract Hospital, Institutes of Mental Disease (IMD), State Hospital, Crisis Residential, Transitional Residential, Super Board and Care, and Residential Care Facility. Days of utilization for each service were multiplied by estimates of the average costs per client, per day provided by the County. To create the primary outcome measure, costs from all of these sources were summed.

    Secondary Outcome Measures

    Total cost of Barbara Arons Pavilion (BAP) Acute Inpatient Psychiatric Care (12 months)
    Total cost of Barbara Arons Pavilion (BAP) Acute Psychiatric Inpatient Care in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Barbara Arons Pavilion (BAP) Acute Inpatient Psychiatric Care (24 months)
    Total cost of Barbara Arons Pavilion (BAP) Acute Psychiatric Inpatient Care in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Barbara Arons Pavilion (BAP) Acute Inpatient Psychiatric Care (36 months)
    Total cost of Barbara Arons Pavilion (BAP) Acute Psychiatric Inpatient Care in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Emergency Psychiatric Services (EPS) - 12 months
    Total cost of Emergency Psychiatric Services (EPS) in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Emergency Psychiatric Services (EPS) - 24 months
    Total cost of Emergency Psychiatric Services (EPS) in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Emergency Psychiatric Services (EPS) - 36 months
    Total cost of Emergency Psychiatric Services (EPS) in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Contract Hospital (12 months)
    Total cost of Contract Hospitals in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Contract Hospital (24 months)
    Total cost of Contract Hospitals in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Contract Hospital (36 months)
    Total cost of Contract Hospitals in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Crisis Residential Facility (12 months)
    Total cost of Crisis Residential Facility care in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Crisis Residential Facility (24 months)
    Total cost of Crisis Residential Facility care in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Crisis Residential Facility (36 months)
    Total cost of Crisis Residential Facility care in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Transitional Residential (12 months)
    Total cost of Transitional Residential care in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Transitional Residential (24 months)
    Total cost of Transitional Residential care in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Transitional Residential (36 months)
    Total cost of Transitional Residential care in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Residential Care Facility (12 months)
    Total cost of Residential Care Facilities in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Residential Care Facility (24 months)
    Total cost of Residential Care Facilities in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Residential Care Facility (36 months)
    Total cost of Residential Care Facilities in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Institutes of Mental Disease (12 months)
    Total cost of Institutes of Mental Disease in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Institutes of Mental Disease (24 months)
    Total cost of Institutes of Mental Disease in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Institutes of Mental Disease (36 months)
    Total cost of Institutes of Mental Disease in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Custody Health (12 months)
    Total cost of Jail-based mental health care in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Custody Health (24 months)
    Total cost of Jail-based mental health care in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Total cost of Custody Health (36 months)
    Total cost of Jail-based mental health care in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Incarceration (12 months)
    Proportion of patients who had any days of incarceration during the 12 months post-enrollment.
    Incarceration (24 months)
    Proportion of patients who had any days of incarceration during the 24 months post-enrollment.
    Incarceration (36 months)
    Proportion of patients who had any days of incarceration during the 36 months post-enrollment.

    Full Information

    First Posted
    August 20, 2023
    Last Updated
    September 22, 2023
    Sponsor
    Stanford University
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT06053346
    Brief Title
    Partners in Wellness: Evaluation of a Pay for Performance Program for High-Utilizers of Mental Health Services
    Official Title
    Evaluation of the Santa Clara County Mental Health Service Pay for Performance Quality Improvement Initiative
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2023
    Overall Recruitment Status
    Completed
    Study Start Date
    August 1, 2016 (Actual)
    Primary Completion Date
    December 31, 2022 (Actual)
    Study Completion Date
    July 1, 2023 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Stanford University

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Healthcare systems in the United States (U.S.) have long faced the considerable challenge of managing budgetary pressures while at the same time helping people with serious mental illness and/or addiction. One potential way to address this challenge is to offer community-based services for individuals who are high-utilizers of expensive emergency and inpatient psychiatric services. Due to the decentralized nature of California governance, responsibility for mental health services falls primarily to the individual counties. The County of Santa Clara, CA invests significantly in community-based services as well as 24-hour care settings. This County adopted an innovative Pay for Performance (PFP) model and contracted with a new care provider to better meet the needs of this patient population and, in turn, reduce demand on the County's 24-hour psychiatric services. Whether this innovative contracting framework will help individuals who thus far have not responded well to mental health services is unknown. The purpose of this study was to determine whether the quality of care for these high-need patients was improved and at a sustainable cost. To this end, a randomized clinical trial (RCT) was conducted to determine whether this innovative quality improvement initiative, referred to as "Partners in Wellness", was successful at reducing the total cost of 24-hour psychiatric care used by enrollees compared to individuals who concurrently received services from the county. Individuals were randomly assigned to the Usual Care (UC) or Pay-For-Performance (PFP) conditions. The primary outcome of this evaluation was reduction in the total cost of 24-hour psychiatric services in the target population. the primary outcome of this evaluation was reduction in the total cost of 24-hour psychiatric services in the target population.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Psychotic Disorders, Bipolar Disorder, Substance Use Disorders

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    652 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Pay For Performance (PFP)
    Arm Type
    Experimental
    Arm Description
    Participants receive a tailored mix of assertive case management, crisis intervention, substance use counseling, mental health treatment, peer support, skill-building and care coordination, among other services delivered by a provider agency contracted by Santa Clara County. Individual and organizational performance incentives relative to traditional contracted service arrangements were also included. Specifically, the agreement between the contracted provider and the County included an agreed schedule of financial rewards and penalties for the contracted provider based on whether its enrollees utilized more or less care than had a historical cohort of patients enrolled before the program began.
    Arm Title
    Usual Care (UC)
    Arm Type
    Active Comparator
    Arm Description
    Participants receive the usual array of mental health and psychosocial services offered by Santa Clara County.
    Intervention Type
    Behavioral
    Intervention Name(s)
    Pay For Performance (PFP)
    Intervention Description
    Wraparound mental health, psychosocial, and addiction treatment services provided by contractor under an schedule of rewards or penalties that was agreed to with Santa Clara County.
    Intervention Type
    Behavioral
    Intervention Name(s)
    Usual Care (UC)
    Intervention Description
    Outpatient and inpatient mental health and psychosocial services delivered by Santa Clara County services and systems.
    Primary Outcome Measure Information:
    Title
    Total cost of 24-hour psychiatric services (12 months)
    Description
    Total cost of the following care types beginning from enrollment until 12 months post-enrollment: Emergency Psychiatric Services (EPS), Barbara Arons Pavilion (BAP) Acute Psychiatric Inpatient, Contract Hospital, Institutes of Mental Disease (IMD), State Hospital, Crisis Residential, Transitional Residential, Super Board and Care, and Residential Care Facility. Days of utilization for each service were multiplied by estimates of the average costs per client, per day provided by the County. To create the primary outcome measure, costs from all of these sources were summed.
    Time Frame
    12 months post-enrollment
    Title
    Total cost of 24-hour psychiatric services (24 months)
    Description
    Total cost of the following care types beginning from enrollment until 24 months post-enrollment: Emergency Psychiatric Services (EPS), Barbara Arons Pavilion (BAP) Acute Psychiatric Inpatient, Contract Hospital, Institutes of Mental Disease (IMD), State Hospital, Crisis Residential, Transitional Residential, Super Board and Care, and Residential Care Facility. Days of utilization for each service were multiplied by estimates of the average costs per client, per day provided by the County. To create the primary outcome measure, costs from all of these sources were summed.
    Time Frame
    24 months post-enrollment
    Title
    Total cost of 24-hour psychiatric services (36 months)
    Description
    Total cost of the following care types beginning from enrollment until 36 months post-enrollment: Emergency Psychiatric Services (EPS), Barbara Arons Pavilion (BAP) Acute Psychiatric Inpatient, Contract Hospital, Institutes of Mental Disease (IMD), State Hospital, Crisis Residential, Transitional Residential, Super Board and Care, and Residential Care Facility. Days of utilization for each service were multiplied by estimates of the average costs per client, per day provided by the County. To create the primary outcome measure, costs from all of these sources were summed.
    Time Frame
    36 months post-enrollment
    Secondary Outcome Measure Information:
    Title
    Total cost of Barbara Arons Pavilion (BAP) Acute Inpatient Psychiatric Care (12 months)
    Description
    Total cost of Barbara Arons Pavilion (BAP) Acute Psychiatric Inpatient Care in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    12 months post-enrollment
    Title
    Total cost of Barbara Arons Pavilion (BAP) Acute Inpatient Psychiatric Care (24 months)
    Description
    Total cost of Barbara Arons Pavilion (BAP) Acute Psychiatric Inpatient Care in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    24 months post-enrollment
    Title
    Total cost of Barbara Arons Pavilion (BAP) Acute Inpatient Psychiatric Care (36 months)
    Description
    Total cost of Barbara Arons Pavilion (BAP) Acute Psychiatric Inpatient Care in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    36 months post-enrollment
    Title
    Total cost of Emergency Psychiatric Services (EPS) - 12 months
    Description
    Total cost of Emergency Psychiatric Services (EPS) in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    12 months post-enrollment
    Title
    Total cost of Emergency Psychiatric Services (EPS) - 24 months
    Description
    Total cost of Emergency Psychiatric Services (EPS) in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    24 months post-enrollment
    Title
    Total cost of Emergency Psychiatric Services (EPS) - 36 months
    Description
    Total cost of Emergency Psychiatric Services (EPS) in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    36 months post-enrollment
    Title
    Total cost of Contract Hospital (12 months)
    Description
    Total cost of Contract Hospitals in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    12 months post-enrollment
    Title
    Total cost of Contract Hospital (24 months)
    Description
    Total cost of Contract Hospitals in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    24 months post-enrollment
    Title
    Total cost of Contract Hospital (36 months)
    Description
    Total cost of Contract Hospitals in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    36 months post-enrollment
    Title
    Total cost of Crisis Residential Facility (12 months)
    Description
    Total cost of Crisis Residential Facility care in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    12 months post-enrollment
    Title
    Total cost of Crisis Residential Facility (24 months)
    Description
    Total cost of Crisis Residential Facility care in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    24 months post-enrollment
    Title
    Total cost of Crisis Residential Facility (36 months)
    Description
    Total cost of Crisis Residential Facility care in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    36 months post-enrollment
    Title
    Total cost of Transitional Residential (12 months)
    Description
    Total cost of Transitional Residential care in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    12 months post-enrollment
    Title
    Total cost of Transitional Residential (24 months)
    Description
    Total cost of Transitional Residential care in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    24 months post-enrollment
    Title
    Total cost of Transitional Residential (36 months)
    Description
    Total cost of Transitional Residential care in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    36 months post-enrollment
    Title
    Total cost of Residential Care Facility (12 months)
    Description
    Total cost of Residential Care Facilities in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    12 months post-enrollment
    Title
    Total cost of Residential Care Facility (24 months)
    Description
    Total cost of Residential Care Facilities in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    24 months post-enrollment
    Title
    Total cost of Residential Care Facility (36 months)
    Description
    Total cost of Residential Care Facilities in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    36 months post-enrollment
    Title
    Total cost of Institutes of Mental Disease (12 months)
    Description
    Total cost of Institutes of Mental Disease in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    12 months post-enrollment
    Title
    Total cost of Institutes of Mental Disease (24 months)
    Description
    Total cost of Institutes of Mental Disease in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    24 months post-enrollment
    Title
    Total cost of Institutes of Mental Disease (36 months)
    Description
    Total cost of Institutes of Mental Disease in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    36 months post-enrollment
    Title
    Total cost of Custody Health (12 months)
    Description
    Total cost of Jail-based mental health care in the 12 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    12 months post-enrollment
    Title
    Total cost of Custody Health (24 months)
    Description
    Total cost of Jail-based mental health care in the 24 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    24 months post-enrollment
    Title
    Total cost of Custody Health (36 months)
    Description
    Total cost of Jail-based mental health care in the 36 months post-enrollment. Days of utilization for this service was multiplied by estimates of the average costs per client, per day provided by the County.
    Time Frame
    36 months post-enrollment
    Title
    Incarceration (12 months)
    Description
    Proportion of patients who had any days of incarceration during the 12 months post-enrollment.
    Time Frame
    12 months post-enrollment
    Title
    Incarceration (24 months)
    Description
    Proportion of patients who had any days of incarceration during the 24 months post-enrollment.
    Time Frame
    24 months post-enrollment
    Title
    Incarceration (36 months)
    Description
    Proportion of patients who had any days of incarceration during the 36 months post-enrollment.
    Time Frame
    36 months post-enrollment

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    65 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Individuals with a history of extensive utilization of 24-hour psychiatric services in Santa Clara County, CA and a likelihood of continuing to use them in the future. Exclusion Criteria: Age 17 or younger Born before 1952 Not current resident of the County Currently residing in a state hospital Registered sex offender with legally imposed residency restrictions Have a DSM-V diagnosis of (or meet diagnostic criteria for): Dementia Autism Spectrum Disorder Catatonia Brief Psychotic Disorder Traumatic head injury resulting in severe cognitive impairment IQ of 69 or lower Eating disorders, including Pica, Anorexia Nervosa and Bulimia Nervosa, or Pyromania, or Psychogenic Polydipsia paired with life threatening behaviors in the past 12 months. Serious risk to self (i.e., suicidal intent with specific plan OR command hallucinations for self-harm that were acted on in the last 30 days and resulted in significant physical injury, or without staff intervention would have resulted in significant physical injury. Risk to others (e.g., sexual aggression or other violent, assaultive behavior toward clinical staff in the past 12 months). Serious medical diagnoses that either require intensive and regular home health care (e.g., Cystic Fibrosis, Parkinson's, Cancer), imminent risk of placement in a Skilled Nursing Facility or nursing home (e.g., non-ambulatory; needing would care), or are terminal or are life-threatening. Significant functional impairments (e.g., unable to toilet, incontinent and refuse to wear diaper, refuse to eat or drink, refuse to dress self or wear clothes, unable to transfer in/out of bed)
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Keith Humphreys, PhD
    Organizational Affiliation
    Professor of Psychiatry
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    Partners in Wellness: Evaluation of a Pay for Performance Program for High-Utilizers of Mental Health Services

    We'll reach out to this number within 24 hrs