Skip Ribbon Commands
Skip to main content
Navigate Up
Sign In

Innovations : familyhealthplan-bridgestoresilience

Clinical Innovations

Title: US Family Health Plan, Bridges to Resilience Program


Organization: Johns Hopkins Healthcare (JHHC)  

What They’re Doing: Screens active duty military personnel and their families for mental and behavioral health issues and connects them with appropriate resources. 

Innovation Type: Care Connections  

Clinical Innovation: The Johns Hopkins USFHP program conducts outreach to active duty military personnel and their families, identifies patients with mental and behavioral health needs and connects them with the appropriate treatments. A counselor screens patients for mental and behavioral health issues by inviting them to complete a survey (currently on paper but soon to be on tablet laptop) as they wait for their primary health care appointment.  If the survey indicates a need, the counselor provides additional assessment and brief interventions and, when appropriate, referral to treatment by network providers. The individuals also receive assistance with scheduling appointments and coordinating authorizations.    

Evaluation Type: Quasi-Experimental    

Evaluation Plan: Clinical data from behavioral health providers will be collected as part of outcomes assessment.  Measures include: percentage of members utilizing behavioral health services, number of behavioral health outpatient visits per 1000 members per year, and behavioral health treatment costs.   

Process measures (i.e., screening rate, interviews, and referrals) are also being recorded by the team.  Claims-based outcome measures are being calculated to assess the effectiveness of the program in increasing the use of behavioral health services.     

A comparison group of members at another primary care site serving a similar military population will be used as a comparison group for primary utilization measures.  The analysis of outcomes will control for patient demographics and health status characteristics in the intervention and comparison sites.  Qualitative research on the process will be conducted to identify factors to predict integration success.  

Patient Health and Cost Outcomes: The analysis of patient outcomes and cost data is still in progress.    

Other Outcomes of Interest: The preliminary results based on the Bridges to Resilience experience since implementation in February 2011 are: USFHP members have completed 470 screening surveys.  Of these, 253 screened positive (54%) for potentially having behavioral healthcare needs.  232 brief interventions have been completed, and the Bridges to Resilience team has made and assisted with 86 (37% of brief interventions) referrals to behavioral health services in the community.  

Publications: None  

Target Population: All patient enrolled in the US Family Health Plan receiving primary health care at the Johns Hopkins Health Care Center at Odenton  

Date of Implementation: February 2011  

Contact: Sara Kachur, Director, Population Health R&D, Johns Hopkins HealthCare LLC; 6704 Curtis Court ; Glen Burnie, MD 21060, 410 424-4673,

Multimedia:   None  

Where to learn more: Please contact Sara Kachur 




Health Care Innovations Graphic