Pragmatic and Innovative Approaches to Evaluating Implementation Costs

Hannah Cheng, MS
Stanford University

Todd Wagner, PhD
Stanford University

ABSTRACT:
This presentation highlights practical and innovative approaches to economic evaluations in implementation endeavors. Part I provides an overview of Delivering Implementation Strategies Cost (DISCo), a pragmatic micro-costing tool that separates delivery and participation costs while outlining practical considerations for measuring implementation costs. Part II discusses economic evaluation approaches beyond traditional cost-effectiveness analysis, focusing on underused or novel approaches, such as data envelopment analysis, stochastic frontier analysis, budget impact analysis, and value-focused methods. The presentation equips researchers with a versatile economic toolkit to understand the value of implementation.

Implementing Collaborative Care at Scale: Insights from a Hybrid Trial and Rapid Expansion

Allison Carroll, PhD
Northwestern University

Meredith Boyd, PhD
Northwestern University

Emily Fu, PhD, MPH
University of Chicago

ABSTRACT:
The Collaborative Care Model (CoCM) is an evidence-based intervention to treat mild to moderate mental health conditions in primary care settings. Although the effectiveness of CoCM has been extensively researched, less is known about the strategies needed to successfully implement and sustain CoCM, particularly under pragmatic conditions. In this presentation, we will share findings from multiple phases of CoCM implementation. First, we conducted a randomized roll-out implementation optimization type 2 hybrid effectiveness-implementation trial of CoCM among 11 clinics within one region of the health system. Second, we will describe how learnings from this phase informed health system-wide implementation of CoCM across 74 clinics. Finally, we will describe novel, rapid approaches that are currently being piloted to increase the adoption and reach of CoCM.

Implementing Collaborative Care for Co-Occurring Disorders in low-resourced settings

Katherine Watkins, MD, MSHS
RAND Corporation

ABSTRACT:
Untreated co-occurring opioid use disorders and mental illness are prevalent and can have devastating consequences for the individual, their families, and the community. The Collaborative Care Model (CoCM) improves outcomes by addressing problems in access and quality for primary care patients with common behavioral health conditions but has not been implemented and tested for co-occurring disorders. This presentation will describe the development and implementation of a CoCM program for co-occurring opioid and mental health disorders in 17 primary care clinics in New Mexico and California. Using Proctor et al.’s 2011/2022 taxonomy of implementation outcomes and data from an ongoing clinical trial, we present the methods used to assess implementation outcomes and results of implementation efforts on model reach and fidelity. We compare the characteristics of individuals who received an initial session with a care coordinator with those whom the care coordinator was unable to engage. Understanding who does and does not receive CC may aid in developing implementation strategies to increase reach and fidelity