A Digital-First Strategy to Provide Evidence-Based Integrated Behavioral Health Treatments in Routine Primary Care

Project Owner

Bruce L. Rollman, MD, MPH, MBA

Proposed Innovation

Depression and anxiety are among the most common conditions seen in primary care, but many patients never receive evidence-based behavioral health treatment. Reasons include limited access to expert care, stigma, and cost. The study team conducted the first NIH-funded trial evaluating the efficacy of Internet-delivered cognitive behavioral therapy (CBT) for depressed and anxious primary care patients through collaborative care. Despite strong trial-based evidence, publication in a high-impact journal, and national attention, digital therapeutics for depression and anxiety remain largely unknown in routine primary care settings.

Improvements in Action

Many clinicians are unfamiliar with CMS billing codes introduced in January 2025 to reimburse physician-prescribed, FDA-approved digital therapeutics. Effective delivery also requires care manager support for patient engagement and specialist oversight, while scalable EHR-based implementation strategies remain largely undeveloped. Finally, patients, providers, and payors may underestimate the clinical, operational, and financial advantages of digital-first collaborative care for high-cost, chronic conditions.

This project will integrate depression and anxiety screening into existing primary care workflows, prioritizing patients with high-cost, chronic conditions (including diabetes, cardiovascular disease, and insomnia), and recent hospital or ED discharges. Improving behavioral health care for these populations can enhance clinical outcomes while potentially increasing primary care practices’ reimbursement from insurers “shared savings” programs that reward value-based care.

Intended Outcomes

Clinical, operational, and financial outcomes will be evaluated to inform the potential broader deployment of digital therapeutics to expand access to evidence-based behavioral health services across the UPMC primary care network.