Kara Zivin, Ph.D., M.S., M.A.
Dr. Zivin’s research applies quantitative methods to mental health services and policy with a focus on predictors and consequences of depression in older adults, Veterans, and other vulnerable populations (including people with multiple medical comorbidities, and people who face barriers accessing and adhering to depression treatment). Her research examines cost-effectiveness of depression care in primary care and specialty mental health settings, mortality risks among patients with depression, employment support needs and productivity, disability, and retirement among those with mood disorders, genetic and psychosocial contributors to late-life depression, and the impact of short- and long-term antidepressant use and adherence on depression, health, and cost outcomes.
- Ph.D., Health Policy, Harvard University
- M.S., Health Policy and Management, Harvard University
- M.A., International Economics and Conflict Management, Johns Hopkins University
- B.A., International Relations, Johns Hopkins University
Health Services Research & Policy Focus
Collaborating Centers & Programs
What are you thinking about?
The Affordable Care Act (ACA) represents one of the largest changes to access and provision of healthcare in our lifetimes and presents an opportunity for many disadvantaged populations to obtain health services who previously had limited options, such as individuals with mental disorders. It also provides the opportunity to develop and study innovative approaches to care coordination for individuals with multiple and complex clinical needs.
Why is this interesting to you?
Treatments for physical and mental disorders have traditionally occurred separately without accounting for the whole person, and costs and use of medical care for individuals with comorbid mental disorders are often higher than for individuals without psychiatric illnesses. Providing financial incentives to integrate mental health care into primary care practices could improve care coordination and overall health outcomes for patients with mental disorders. I am interested in studying the impact of such incentives, and consequently, I am working with the Center for Medicare and Medicaid Innovation (CMMI) and their Comprehensive Primary Care Initiative (CPC), which includes 497 practices in seven regions in the US and is providing financial incentives for improved care coordination over a four year period. This work is part of my participation as a 2013-2014 Health and Aging Policy Fellow, funded by the Atlantic Philanthropies, which is a unique opportunity for professionals in health and aging to receive the experience and skills necessary to make a positive contribution to the development and implementation of health policies that affect older Americans.
What are the practical implications for healthcare?
Although there are many reasons to be cautiously optimistic about opportunities for improved access and coordination of care under the ACA, there are also many unanswered questions about how these changes will be implemented, whether increased demand will be met with sufficient supply of appropriate providers to meet these needs, and how the changes under the ACA relate to longer term outcomes and costs. I believe IHPI can and should be at the forefront of evaluating the outcomes of these important changes to healthcare provision.