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Balancing Value and Cost

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Handbook of Clinical Psychology in Medical Settings

Abstract

Behavioral conditions such as depression , anxiety and substance use disorders, stress and adjustment disorders, and lifestyle habits such as smoking, overeating, and lack of exercise all contribute to worse outcomes and higher costs for patients with chronic medical conditions as reported by Kathol et al. (J Gen Int Med 20:160–167, 2005) and McGinnis et al. (JAMA 270:2207–2212, 1993). Patients with comorbid medical and behavioral conditions are seen mostly in primary care settings where the behavioral conditions that contribute to adverse health outcomes are largely undetected or, when diagnosed, are offered inadequate treatment that does not meet evidence-based practice guidelines as reported by McGlynn et al. (N Engl J Med 348:2635–2645, 2003). There is a long-standing and growing body of evidence that targeted, focused behavioral interventions delivered in primary care settings can improve both health outcomes and reduce excessive medical costs for patients with chronic medical conditions and patterns of high utilization of health care services as reported by Chiles et al. (The impact of medical cost offset on practice and research: making it work for you, Context, Reno, 2002, 47–56).

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Authors and Affiliations

  1. College of Health Solutions, Arizona State University, Mail Code 3252, P.O. Box 37100, 85069-7100, Phoenix, AZ, USA

    Ronald R. O’Donnell Ph.D. & Janet L. Cummings Psy.D.

  2. University of Nevada, Reno, NV, USA

    Nicholas A. Cummings Ph.D., Sc.D.

  3. Cummings Foundation for Behavioral Health, Inc., 4781 Caughlin Parkway, 89519, Reno, NV, USA

    Nicholas A. Cummings Ph.D., Sc.D.

  4. The Nicholas & Dorothy Cummings Foundation, Inc., Reno, NV, USA

    Nicholas A. Cummings Ph.D., Sc.D.

  5. CareIntegra, Reno, NV, USA

    Nicholas A. Cummings Ph.D., Sc.D.

  6. American Psychological Association, Washington, DC, USA

    Nicholas A. Cummings Ph.D., Sc.D.

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  1. Ronald R. O’Donnell Ph.D.
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  1. Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes & Digestive & Kidney Diseases, Bethesda, Maryland, USA

    Christine M. Hunter

  2. Patient-Centered Medical Home Branch, Clinical Support Division, Defense Health Agency, Falls Church, Virginia, USA

    Christopher L. Hunter

  3. Fletcher Allen Health Care, Inc., Montpelier, Vermont, USA

    Rodger Kessler

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O’Donnell, R., Cummings, N., Cummings, J. (2014). Balancing Value and Cost. In: Hunter, C., Hunter, C., Kessler, R. (eds) Handbook of Clinical Psychology in Medical Settings. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09817-3_8

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