Outcomes looking good for WPS midway through Depression Screening Innovation Challenge

MADISON, Wis.—May 23, 2023—At WPS Health Solutions, the company’s WPS Government Health Administrators division has reached the halfway point in its 12-month Depression Screening Innovation Challenge Grant project issued by The Centers for Medicare & Medicaid Services. Midway through the project, the outcomes of the division’s efforts look promising. 

In November 2019, CMS issued a challenge to Medicare Administrative Contractors. WPS accepted the challenge and is now in its third year of working toward increasing the use of chronic care management and depression screening for Medicare beneficiaries in Medicare Jurisdictions 5 and 8. Based upon success in years one and two, WPS added combating health inequities to the project’s scope.    

The Innovation Challenge project team is led by the WPS Government Health Administrators Medical Director, Dr. Joelle Vlahakis. Her team includes data analysts, educators, billing specialists, and a population health specialist.  

"Innovation requires the willingness to recognize when an idea needs to be altered or abandoned in favor of a better idea, and we are up for the challenge," Vlahakis said. "Our priorities align with CMS’ priorities, and we have a special interest in areas where health care disparities are high."  

The company's efforts in the first and second years of the depression screening pilot were successful, and WPS saw a 13% increase in screening in Jurisdiction 8 in the first year alone. Increased depression screening appears to have lowered the rate of suicide attempts in both jurisdictions in the project’s first two years.  

"When patients enroll in chronic care management, their care is focused on what makes their life better. Care is less fragmented and dependent upon the use of emergency rooms or hospital stays. And providers of the care report that they can spend more time seeing patients face to face and less time managing crises," Vlahakis said. 

Building on its success, WPS is using the Area Deprivation Index—a measure for the theoretical domains of income, education, employment, and housing quality—to combat health inequities in Jurisdiction 8. The ADI and beneficiaries' ages are potent predictors of the risk of depression. ADI has been the foundation for WPS identifying places where social determinants of health are most likely to contribute to health inequities. 

"Our project team has found that connecting with organizations, societies, and other large groups has been productive and instructive. Aligning ourselves with such stakeholders, especially those whose purpose is to address the social drivers of health, has been especially compelling and useful. What we did not expect is that our one-on-one conversations with individual providers, clinicians, administrators, or even beneficiaries would also shape our approach to the project," Vlahakis explained. 

The Innovation Challenge core work group is divided into two smaller groups. One work group focuses on the data and its analysis, and the other on educational outreach.   

Through WPS' Provider Outreach and Education Department, the team educates practitioners, clinicians, and their support teams through webinars, a YouTube channel, and in-person events. Audiences vary (support staff, clinical staff, and providers, for example), and discussions are tailored to the skills demanded of each role. The team has worked to create a platform for high-quality education that is simple and accessible.  

Data analysis is another driving force in what WPS is accomplishing. Employees are examining and targeting their efforts based on three major points of data: 

  • Health care providers with a low utilization rate of depression screening  
  • Health care providers with the greatest number of beneficiaries in their jurisdiction  
  • An ADI score that falls greater than the 70th percentile where the risk of depression is highest 

WPS reported the following for Jurisdiction 8:  

  • Based on 2021 data, WPS has established an average monthly goal of 7,341 depression screening claims. According to Medicare claims data from September 2022 to February 2023, WPS averaged 7,641 claims per month, which is 300 claims above the goal and is a 9% increase from 2021. 
  • To analyze the efficacy of the educational intervention program on the most at-risk Medicare beneficiaries, WPS is tracking the primary benchmark of a 2.5% increase in depression screening claim count for beneficiaries who live in the most at-risk neighborhoods. Based on 2021 data, WPS has established an average monthly goal of 2,444 depression screening claims. In the second quarter of year three, WPS averaged 2,366 claims per month, which is 78 claims below the goal and a 1% decrease from 2021.  
  • To analyze the downstream impacts of its educational intervention program, WPS is tracking the primary benchmark of a 5% reduction in the number of claims featuring a suicide attempt diagnosis. Based on 2021 data, WPS established a monthly goal of 82 claims featuring a suicide attempt. In the second quarter of year three, WPS averaged 51 claims per month, which is 31 claims beyond the goal and equates to a 41% decrease from 2021. 

About WPS Health Solutions®

Wisconsin Physicians Service Insurance Corporation (WPS Health Solutions), founded in 1946, is a nationally regarded benefits administrator for a variety of U.S. government programs and a leading not-for-profit health insurer in Wisconsin. WPS Health Solutions serves active-duty and retired military personnel, seniors, individuals, and families in Wisconsin, across the U.S., and around the world. WPS Health Solutions, headquartered in Madison, Wis., has more than 2,600 employees. Within the enterprise, there are three divisions: WPS Government Health Administrators, WPS Military and Veterans Health, and WPS Health Insurance/WPS Health Plan/EPIC Specialty Benefits. For more information, please visit wpshealthsolutions.com.

About WPS Government Health Administrators®

As a large contractor for the Centers for Medicare & Medicaid Services, WPS Government Health Administrators, a division of Wisconsin Physicians Service Insurance Corporation, manages Medicare Part A and Part B benefits for more than 7 million seniors in multiple states. WPS Government Health Administrators is headquartered in Madison, Wis. Visit the WPS Health Solutions About page for more information.