IMPACT

At a Glance

National Office: 
1959 NE Pacific St. Box 356560
Seattle, WA 98195-6560

Jurgen Unutzer
People Served: 
5,000
Tax ID: 
91-6001537

Focus area(s):

Health Services/Access
Health Services
Mental Health

Description

IMPACT is an evidence-based, collaborative care model that trains a team of professionals – a primary care physician, care manager, and psychiatric consultant – to integrate the treatment of common mental health conditions, such as depression and anxiety, into their primary care or other medical setting.

Impact and Outcomes

Reduction in depression symptoms
Improvement of functional status and quality of life
Lower average cost for medical care

Mission & Goals

IMPACT is an evidence-based approach to increasing access to effective treatment for common mental health conditions like depression and anxiety by improving capacity in primary care and similar settings where patients are most likely to seek help.  This proven approach is most commonly referred to as “Integrated Care” or “Collaborative Care” and has been proven effective in over 80 peer-reviewed research trials worldwide.

The implementation of this Collaborative Care model is both necessary and timely, as it aligns with the goals of the Affordable Care Act, including patient-centered, integrated, whole-person care designed to produce better outcomes at lower cost.

Program

In the IMPACT model, patients with depression are treated by a collaborative care team that includes the primary care provider (PCP), the care manager who is a liaison between the patient and doctors, and a psychiatric consultant. The PCP screens for depression using a standardized tool, and patients whose scores indicate depression are brought to the attention of the team. Patients are regularly re-assessed to determine whether treatment is working. Typical treatment duration is six months, with some patients needing as little as three months and some needing more than 12 months, depending on how many changes in treatment are needed to achieve sufficient improvement. Those who are not responding to initial treatment “step up” to a more intensive approach designed by the collaborative care team.  
 
KEY ELEMENTS OF THE IMPACT MODEL
 
  •     Patients demonstrating symptoms of depression are screened and if needed, referred to the care manager
  •     The collaborative care team, working with the patient, creates a treatment plan for patients whose scores indicate depression
  •     The care manager supports all prescribed therapies, offers counseling, monitors symptoms for treatment response, and develops a relapse         prevention plan
  •     The team reviews each case weekly. Cases not responding as anticipated (50% reduction in symptoms within 3 months) are “stepped up” to       adjust or intensify treatment  
  •     Symptoms are regularly measured throughout

Impact

The IMPACT model has been the subject of multiple randomized control trial studies examining its effectiveness in different settings and among different populations; the evidence documenting IMPACT’s positive results is unusually robust. In one of the largest randomized control trials for depression to date, a team of researchers studied the effectiveness of the IMPACT model in 1,801 depressed, older adults from 18 diverse primary care clinics associated with eight healthcare organizations across the United States showed the following results:

  • Overall, patients assigned to the IMPACT group were more than twice as likely to experience a 50% reduction in depression symptoms as patients receiving usual care
  • Patients suffering from osteoarthritis and co-morbid depression experienced a reduction in pain and improved functional status and quality of life (in addition to reduced depressive symptoms)
  • Physical functioning was found to be significantly better for patients in the IMPACT group than those in usual care
  • Cost data from two of the HMOs participating in the trial showed that IMPACT patients had lower average costs for all their medical care—about $3,300 less than patients assigned to usual care over a four-year period, even when factoring in the cost of IMPACT care

Growth Plan

Over the next three years, the AIMS Center will replicate the IMPACT model at 5-8 Federally Qualified Health Centers serving at least 8,000 people in low-income, rural communities in Wyoming, Washington, Alaska, Montana, and Idaho, while building the knowledge base to support successful replication in underserved rural communities.

1. Replication of IMPACT through training and technical assistance to primary care practices. Practices, health plans and other funders pay the AIMS Center to provide training and technical assistance over a three to six month period. Initial training is followed by post-launch technical assistance and support that can continue for up to 24 months, depending on an organization’s needs.
2. State and federal advocacy supporting policies allowing insurers to reimburse practices offering IMPACT or similar collaborative care services. Enabling reimbursement from insurers for the cost of collaborative care services would ensure IMPACT’s financial viability at the clinic or practice level. Further, insurers would save significantly through prevention of costly conditions that result from untreated depression.
3. Social Innovation Fund Demonstration. In 2012, the John A. Hartford Foundation and the AIMS Center won a federal Social Innovation Fund award to replicate IMPACT at 5-8 Federally Qualified Health Centers (FQHCs) in low-income, rural communities in Wyoming, Washington, Alaska, Montana, and Idaho -- benefiting a minimum of 8,000 patients over three years. Other activities include new research on IMPACT’s role in reducing health care costs, enhanced on-site implementation assistance for some sites, and specialized technical assistance to ensure IMPACT’s financial sustainability after SIF funding has ended.
4. Business planning process. The AIMS Center will develop a comprehensive business plan for scaling
IMPACT to serve millions of Americans across the country.

Location of Sites

National Office: 
1959 NE Pacific St. Box 356560
Seattle, WA 98195-6560
List of locations

To make a contribution to a program site:

  1. Click on the "Make a Contribution Now" button and include the name, city and state of the program you would like to support, in the "notes" text box on the organization's donation form, if available.
  2. If a "notes" or "designation" box is not available, write the city and state on your check in the "notes" section or call the national office to designate your contribution to a local program site.

Locations in the following states:

No results found.

Financials

Most Recent Budget

Year Ended:

2013

REVENUE

Corporate Grants: 
$47,520
Foundation Grants: 
$401,013
Government Funding: 
$282,939
Contributions from Individuals: 
$49,391
Special Events: 
$0
Program Services Fees: 
$1,833,500
Membership Dues: 
$0
Other Earned Income: 
$0
Other Revenue: 
$0
Total Revenue: 
$2,614,363

EXPENSES

Salaries, Related Salaries & Professional Fees: 
$2,110,443
Occupancy: 
$141,261
Travel & Entertainment: 
$66,294
Office Supplies, Printing, Postage: 
$8,634
Telephone & Communications: 
$21,126
Payments to Affiliates: 
$195,783
Other Expenses: 
$5,250
Other Expenses (Description): 

 

Other Expenses (Description): 

 

Other Expenses (Description): 

Total Expenses: 
$2,548,791

NET GAIN/LOSS

Net Gain/Loss: 
$65,572

Prior Year Actuals

REVENUE

Corporate Grants: 
$53,370
Foundation Grants: 
$379,321
Government Funding: 
$361,121
Contributions from Individuals: 
$0
Program Services Fees: 
$1,760,567
Membership Dues: 
$0
Other Earned Income: 
$0
Other Revenue: 
$0
Special Events: 
$0
Total Revenue: 
$2,554,379

EXPENSES

Salaries, Related Salaries & Professional Fees: 
$1,842,978
Occupancy: 
$123,309
Travel & Entertainment: 
$68,242
Office Supplies, Printing, Postage: 
$67,051
Telephone & Communication: 
$81,788
Payments to Affiliates: 
$131,833
Other Expenses: 
$7,600
Other Expenses (Description): 

 

Total Expenses: 
$2,322,801

NET GAIN/LOSS

Net Gain / Loss: 
$231,578

Major Funders

Alameda County (CA) Behavioral Health
Archstone Foundation
California Institute for Mental Health
Commonwealth Fund
Community Healthplan of Washington
Department of Defense
George Foundation
Henry M Jackson Foundation
Hogg Foundation for Mental Health
HRSA
John A Hartford Foundation
Los Angeles County (CA) Department of Mental Health
New York State Department of Health
New York State Department of Mental Health
Public Health-Seattle and King County
Santa Clara County (CA) Behavioral Health
University of Alberta (Canada) CMTS Only
UW Center for Commercialization Gap Fund
Wyoming Medicaid